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Gumpert M, Rautio D, Monzani B, Jassi A, Krebs G, Fernández de la Cruz L, Mataix-Cols D, Jansson-Fröjmark M. Psychometric evaluation of the appearance anxiety inventory in adolescents with body dysmorphic disorder. Cogn Behav Ther 2024; 53:254-266. [PMID: 38174353 DOI: 10.1080/16506073.2023.2299837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 12/18/2023] [Indexed: 01/05/2024]
Abstract
The Appearance Anxiety Inventory (AAI) is a self-report measure assessing the typical cognitions and behaviours of body dysmorphic disorder (BDD). Despite its use in research and clinical settings, its psychometric properties have not been evaluated in young people with BDD. We examined the factor structure, reliability, validity, and sensitivity to change of the AAI in 182 youths with BDD (82.9% girls; Mage = 15.56, SD = 1.37) consecutively referred to two specialist outpatient clinics in Stockholm, Sweden (n = 97) and London, England (n = 85). An exploratory factor analysis identified three factors, namely "threat monitoring", "camouflaging", and "avoidance", explaining 48.15% of the variance. The scale showed good internal consistency (McDonalds omega = 0.83) and adequate convergent validity with the Yale-Brown Obsessive-Compulsive Scale Modified for Body Dysmorphic Disorder for Adolescents (BDD-YBOCS-A; rs = 0.42) and the Clinical Global Impression-Severity Scale (rs = 0.32). Sensitivity to change was adequate, with AAI total scores and individual factor scores significantly decreasing over time in the subgroup of participants receiving multimodal treatment for BDD (n = 79). Change of AAI scores over treatment showed a positive statistically significant moderate-to-good correlation (r = 0.55) with changes in BDD symptom severity, measured by the BDD-YBOCS-A. The study provides empirical support for the use of the AAI in young people with BDD in clinical settings.
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Affiliation(s)
- Martina Gumpert
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Daniel Rautio
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Benedetta Monzani
- National and Specialist OCD, BDD, and Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Amita Jassi
- National and Specialist OCD, BDD, and Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Georgina Krebs
- National and Specialist OCD, BDD, and Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, United Kingdom
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - Lorena Fernández de la Cruz
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - David Mataix-Cols
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Markus Jansson-Fröjmark
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
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Lisøy C, Neumer SP, Adolfsen F, Ingul JM, Potulski Rasmussen LM, Wentzel-Larsen T, Patras J, Sund AM, Ytreland K, Waaktaar T, Holen S, Askeland AL, Haug IM, Bania EV, Martinsen K. Optimizing indicated cognitive behavioral therapy to prevent child anxiety and depression: A cluster-randomized factorial trial. Behav Res Ther 2024; 176:104520. [PMID: 38522127 DOI: 10.1016/j.brat.2024.104520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 12/12/2023] [Accepted: 03/13/2024] [Indexed: 03/26/2024]
Abstract
Identifying effective components can lead to interventions that are less resource-intensive and better suited for real-world needs. In this 2×2×2 cluster-randomized factorial trial (clinicaltrials.gov NCT04263558), we investigated the effects of three components of an indicated, transdiagnostic CBT intervention for children: 1) Intervention Delivery Format (child group format versus a blended format with group sessions and automated web-based sessions), 2) Parental Involvement in the intervention (group-based versus psychoeducational brochure), and 3) a Measurement Feedback System (MFS; on versus off). The intervention was delivered at schools in a group-based format. The participants (N = 701 children) were school children (age 8-12 years) with elevated symptoms of anxiety or depression, and their parents. The main outcomes were self-reported (N = 633) and parent-reported (N = 725) symptoms of child anxiety and depression post-intervention. The secondary outcome was children's user satisfaction with the intervention. We did not find significant main or interaction effects of Delivery Format, Parental Involvement, or MFS on children's symptom levels. There were no significant effects on children's user satisfaction. Results were compatible with retaining the least resource intensive combination (i.e., blended format, parental brochure, no MFS) in an optimized intervention.
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Affiliation(s)
- Carina Lisøy
- Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP Øst og Sør, Postboks 4623 Nydalen, 0405, Oslo, Norway; Department of Psychology, University of Oslo, Harald Schjelderups hus Forskningsveien 3A, 0373, Oslo, Norway.
| | - Simon-Peter Neumer
- Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP Øst og Sør, Postboks 4623 Nydalen, 0405, Oslo, Norway.
| | - Frode Adolfsen
- Regional Centre for Child and Youth Mental Health and Child Welfare - Northern Norway, UiT - The Arctic University of Norway (UiT Norges Arktiske Universitet, Det helsevitenskapelige Fakultet, RKBU Nord, Varemottak-MH, Plan 6, Sykehusv. 44 9019 Tromsø, Norway.
| | - Jo Magne Ingul
- Regional Centre for Child and Youth Mental Health and Child Welfare - Central Norway, Department of Mental Health, Norwegian University of Science and Technology (NTNU, RKBU Midt-Norge, 7491, Trondheim, Norway.
| | - Lene-Mari Potulski Rasmussen
- Regional Centre for Child and Youth Mental Health and Child Welfare - Northern Norway, UiT - The Arctic University of Norway (UiT Norges Arktiske Universitet, Det helsevitenskapelige Fakultet, RKBU Nord, Varemottak-MH, Plan 6, Sykehusv. 44 9019 Tromsø, Norway.
| | - Tore Wentzel-Larsen
- Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP Øst og Sør, Postboks 4623 Nydalen, 0405, Oslo, Norway.
| | - Joshua Patras
- Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP Øst og Sør, Postboks 4623 Nydalen, 0405, Oslo, Norway.
| | - Anne Mari Sund
- Regional Centre for Child and Youth Mental Health and Child Welfare - Central Norway, Department of Mental Health, Norwegian University of Science and Technology (NTNU, RKBU Midt-Norge, 7491, Trondheim, Norway.
| | - Kristin Ytreland
- Regional Centre for Child and Youth Mental Health and Child Welfare - Central Norway, Department of Mental Health, Norwegian University of Science and Technology (NTNU, RKBU Midt-Norge, 7491, Trondheim, Norway.
| | - Trine Waaktaar
- Department of Psychology, University of Oslo, Harald Schjelderups hus Forskningsveien 3A, 0373, Oslo, Norway.
| | - Solveig Holen
- Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP Øst og Sør, Postboks 4623 Nydalen, 0405, Oslo, Norway.
| | - Anne Liv Askeland
- Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP Øst og Sør, Postboks 4623 Nydalen, 0405, Oslo, Norway.
| | - Ida Mari Haug
- Regional Centre for Child and Youth Mental Health and Child Welfare - Northern Norway, UiT - The Arctic University of Norway (UiT Norges Arktiske Universitet, Det helsevitenskapelige Fakultet, RKBU Nord, Varemottak-MH, Plan 6, Sykehusv. 44 9019 Tromsø, Norway.
| | - Elisabeth Valmyr Bania
- Regional Centre for Child and Youth Mental Health and Child Welfare - Central Norway, Department of Mental Health, Norwegian University of Science and Technology (NTNU, RKBU Midt-Norge, 7491, Trondheim, Norway.
| | - Kristin Martinsen
- Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP Øst og Sør, Postboks 4623 Nydalen, 0405, Oslo, Norway; Department of Psychology, University of Oslo, Harald Schjelderups hus Forskningsveien 3A, 0373, Oslo, Norway.
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Rautio D, Andrén P, Bjureberg L, Silverberg-Mörse M, Mataix-Cols D, Fernández de la Cruz L. Body-Focused Repetitive Behavior Disorders in Children and Adolescents: Clinical Characteristics and Treatment Outcomes in a Naturalistic Setting. Behav Ther 2024; 55:376-390. [PMID: 38418047 DOI: 10.1016/j.beth.2023.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 07/14/2023] [Accepted: 07/20/2023] [Indexed: 03/01/2024]
Abstract
Body-focused repetitive behavior disorders, including trichotillomania (hair-pulling disorder) and excoriation (skin picking) disorder, typically emerge in early adolescence, but little is known about the clinical characteristics and treatment outcomes of these disorders in young people, particularly in real-world clinical settings. Participants were 63 children and adolescents (51 girls; age range 9-17) with a diagnosis of trichotillomania (n = 33) and/or skin-picking disorder (n = 33) attending a specialist outpatient clinic in Stockholm, Sweden. Demographic and clinical characteristics were gathered at the initial assessment. Of the 63 assessed youths, 56 received manual-based behavior therapy mainly focusing on habit reversal training, which was combined with medication when deemed appropriate. The mean clinician-reported trichotillomania and skin-picking disorder symptom severity at baseline (n = 63) was in the moderate range. We observed high rates of psychiatric comorbidity (63.5%) and use of psychiatric medication (54.8%). For the 56 individuals undertaking treatment at the clinic, mixed-effects regression models showed a significant decrease in symptom severity from baseline to posttreatment, with gains maintained up to the 12-month follow-up. Substantial and durable improvements were also seen on self-reported symptoms, self-reported depression, and global functioning. Specialist care should be made more widely available to improve the prognosis and quality of life of young people with trichotillomania and skin-picking disorder.
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Affiliation(s)
- Daniel Rautio
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, and Stockholm Health Care Services, Region Stockholm.
| | - Per Andrén
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm Health Care Services, and Lund University
| | | | | | - David Mataix-Cols
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm Health Care Services, Region Stockholm, and Lund University
| | - Lorena Fernández de la Cruz
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm
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Bilgin A, Wolke D, Trower H, Baumann N, Räikkönen K, Heinonen K, Kajantie E, Schnitzlein D, Lemola S. Emotional problems and peer victimization in adolescents born very preterm and full-term: Role of self-control skills in childhood. Dev Psychopathol 2024; 36:302-311. [PMID: 36453116 DOI: 10.1017/s0954579422001201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
The aim of the current study was to examine whether self-control skills in childhood moderate the association between very preterm birth (<32 weeks of gestational age) and emotional problems and peer victimization in adolescence. We used data from four prospective cohort studies, which included 29,378 participants in total (N = 645 very preterm; N = 28,733 full-term). Self-control was mother-reported in childhood at 5-11 years whereas emotional problems and peer victimization were both self- and mother-reported at 12-17 years of age. Findings of individual participant data meta-analysis showed that self-control skills in childhood do not moderate the association between very preterm birth and adolescence emotional problems and peer victimization. It was shown that higher self-control skills in childhood predict lower emotional problems and peer victimization in adolescence similarly in very preterm and full-term borns.
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Affiliation(s)
- Ayten Bilgin
- School of Psychology, University of Kent, Canterbury, UK
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, UK
| | - Hayley Trower
- Division of Health Sciences, Mental Health and Wellbeing Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Nicole Baumann
- Department of Psychology, University of Warwick, Coventry, UK
- Department of Health Sciences, University of Leicester, Leicester, UK
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Katri Räikkönen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Kati Heinonen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
- Psychology/Welfare Sciences, Tampere University, Tampere, Finland
| | - Eero Kajantie
- Finnish Institute for Health and Welfare, Helsinki, Finland
- PEDEGO Research Unit, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Sakari Lemola
- Department of Psychology, University of Warwick, Coventry, UK
- Department of Psychology, Bielefeld University, Bielefeld, Germany
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Ballard R, Parkhurst JT, Gadek LK, Julian KM, Yang A, Pasetes LN, Goel N, Sit DK. Bright Light Therapy for Major Depressive Disorder in Adolescent Outpatients: A Preliminary Study. Clocks Sleep 2024; 6:56-71. [PMID: 38390946 PMCID: PMC10885037 DOI: 10.3390/clockssleep6010005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/24/2024] [Accepted: 01/25/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Bright light therapy (BLT) has not been well-studied in adolescents with major depressive disorder, particularly in outpatient settings. METHODS We conducted an 8-week clinical trial of BLT in adolescents recruited from a primary care practice with moderate to severe major depression. Acceptability and feasibility were defined by daily use of the light box and integration into daily routines. To assess treatment effects, we utilized the Short Mood and Feelings Questionnaire (SMFQ) and actigraphic sleep variables. RESULTS Of the nine enrolled adolescents, the rate of daily use of the light therapy box was 100% at week 2, 78% at week 4 (n = 7), and 67% at weeks 6 and 8 (n = 6). Participants were better able to integrate midday BLT compared to morning BLT into their day-to-day routines. Mean depression scores improved during the 2-week placebo lead-in (dim red light-DRL) and continued to show significant improvement through 6 weeks of BLT. Sleep efficiency increased significantly (p = 0.046), and sleep onset latency showed a trend toward a significant decrease (p = 0.075) in the BLT phase compared to the DRL phase. CONCLUSION Bright light treatment that was self-administered at home was feasible, acceptable, and effective for adolescent outpatients with depression. Findings support the development of larger, well-powered, controlled clinical trials of BLT in coordination with primary care.
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Affiliation(s)
- Rachel Ballard
- Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave., Box 10, Chicago, IL 60611, USA
| | - John T Parkhurst
- Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave., Box 10, Chicago, IL 60611, USA
| | - Lisa K Gadek
- Lake Forest Pediatrics, Lake Bluff, IL 60044, USA
| | - Kelsey M Julian
- Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave., Box 10, Chicago, IL 60611, USA
| | - Amy Yang
- Asher Center for the Study and Treatment of Depressive Disorders, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 N. St. Clair St., Suite 1000, Chicago, IL 60611, USA
| | - Lauren N Pasetes
- Biological Rhythms Research Laboratory, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 425, Chicago, IL 60612, USA
| | - Namni Goel
- Biological Rhythms Research Laboratory, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 425, Chicago, IL 60612, USA
| | - Dorothy K Sit
- Asher Center for the Study and Treatment of Depressive Disorders, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 N. St. Clair St., Suite 1000, Chicago, IL 60611, USA
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Amelio P, Antonacci C, Khosravi P, Haller S, Kircanski K, Berman E, Cullins L, Lewis K, Davis M, Engel C, Towbin K, Stringaris A, Pine DS. Evaluating the development and well-being assessment (DAWBA) in pediatric anxiety and depression. Child Adolesc Psychiatry Ment Health 2024; 18:12. [PMID: 38245769 PMCID: PMC10800067 DOI: 10.1186/s13034-023-00696-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 12/19/2023] [Indexed: 01/22/2024] Open
Abstract
Enhancing screening practices and developing scalable diagnostic tools are imperative in response to the increasing prevalence of youth mental health challenges. Structured lay psychiatric interviews have emerged as one such promising tool. However, there remains limited research evaluating structured psychiatric interviews, specifically their characterization of internalizing disorders in treatment-seeking youth. This study evaluates the relationship between the Development and Well-Being Assessment (DAWBA), a structured psychiatric interview, and established measures of pediatric anxiety and depression, including the Screen for Child Anxiety Related Disorders (SCARED), the Pediatric Anxiety Rating Scale (PARS), and the Mood and Feelings Questionnaire (MFQ). The study comprised two independent clinical samples of treatment-seeking youth: sample one included 55 youth with anxiety and 29 healthy volunteers (HV), while sample two included 127 youth with Major Depressive Disorder and 73 HVs. We examined the association between the DAWBA band scores, indicating predicted risk for diagnosis, the SCARED and PARS (sample one), and the MFQ (sample two). An exploratory analysis was conducted in a subset of participants to test whether DAWBA band scores predicted the change in anxiety symptoms (SCARED, PARS) across a 12-week course of cognitive behavioral therapy. The results revealed that the DAWBA significantly predicted the SCARED, PARS and MFQ measures at baseline; however, it did not predict changes in anxiety symptoms across treatment. These findings suggest that the DAWBA may be a helpful screening tool for indexing anxiety and depression in treatment-seeking youth but is not especially predictive of longitudinal trajectories in symptomatology across psychotherapy.
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Affiliation(s)
- Paia Amelio
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Chase Antonacci
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Parmis Khosravi
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA.
| | - Simone Haller
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Katharina Kircanski
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Erin Berman
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Lisa Cullins
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Krystal Lewis
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Mollie Davis
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Chana Engel
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Kenneth Towbin
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Argyris Stringaris
- Divisions of Psychiatry and Psychology and Language Science, University College London, London, UK
- National and Kapodistrian University of Athens, Athens, Greece
| | - Daniel S Pine
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
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Martinsen K, Lisøy C, Wentzel-Larsen T, Neumer SP, Rasmussen LMP, Adolfsen F, Sund AM, Ingul JM. School children's mental health during the COVID-19 pandemic. Front Psychol 2024; 14:1290358. [PMID: 38327509 PMCID: PMC10848797 DOI: 10.3389/fpsyg.2023.1290358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/13/2023] [Indexed: 02/09/2024] Open
Abstract
Introduction The COVID-19 pandemic significantly impacted the daily routines of children, with social distancing and quarantine leading to reduced social interactions and potential increased conflicts within families. These factors can increase the risk for anxiety and depression while reducing overall quality of life. Methods Our study included 1843 school children aged 8 to 12 from 56 schools over a 2.5-year period before and during the pandemic. This multi-wave cross-sectional study utilized baseline data from an optimization trial of an indicated preventive intervention. The main outcomes were self-reported symptoms of anxiety and depression, and quality of life was the secondary outcome measure. Furthermore, responses to COVID-relevant questions were measured using a self-composed scale. Our objectives were to compare anxiety and depression symptom levels between cohorts of children who participated in the study before and during the pandemic, to examine if anxiety or depression predicted the COVID response, and whether anxiety and depression and subtypes of anxiety had an impact on quality of life during the pandemic. Linear regression and interaction models were used to examine relevant associations. Results Levels of anxiety and depression were higher in all waves compared to pre-pandemic levels. Quality of life was lower during the pandemic than before the pandemic, particularly among children with generalized anxiety symptoms. Quality of life was negatively associated with loneliness. Discussion Our study revealed that children reported higher anxious and depressive symptoms during the pandemic compared to pre-pandemic levels, as well as reduced quality of life. Lockdowns and restrictions may have contributed to this burden. Additionally, self-reported loneliness was a significant possible consequence of the restrictive measures imposed on children during the pandemic. Additional research is needed to investigate the long-term effects of the pandemic on children, particularly regarding the stability of elevated levels of anxiety and depression. Such studies could examine whether these conditions are indicative of a trajectory toward more severe internalizing disorders.Clinical trial registration: NCT04263558.
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Affiliation(s)
- Kristin Martinsen
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
- Regional Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
| | - Carina Lisøy
- Regional Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
| | - Tore Wentzel-Larsen
- Regional Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
| | - Simon-Peter Neumer
- Regional Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
- Regional Centre for Child and Youth Mental Health and Child Welfare - North, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway
| | - Lene-Mari Potulski Rasmussen
- Regional Centre for Child and Youth Mental Health and Child Welfare - North, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway
| | - Frode Adolfsen
- Regional Centre for Child and Youth Mental Health and Child Welfare - North, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway
| | - Anne Mari Sund
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Department of Mental Health, Faculty of Medicine and Health Sciences, NTNU, Trondheim, Norway
| | - Jo Magne Ingul
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Department of Mental Health, Faculty of Medicine and Health Sciences, NTNU, Trondheim, Norway
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Prizeman K, McCabe C, Weinstein N. Stigma and its impact on disclosure and mental health secrecy in young people with clinical depression symptoms: A qualitative analysis. PLoS One 2024; 19:e0296221. [PMID: 38180968 PMCID: PMC10769096 DOI: 10.1371/journal.pone.0296221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/07/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND Clinical depression ranks as a leading cause of disease and disability in young people worldwide, but it is widely stigmatized. The aim of this qualitative research was to gather young people's experiences of depression stigma and its impact on loneliness, social isolation, and mental health disclosure and secrecy. This novel information can then be used to guide psychosocial interventions for young people with depression. METHODS This qualitative study included N = 28 young people aged 18-25 years (Mage = 21.30). Participants were recruited from the community who had high symptoms of depression (assessed through a pre-screen using the Mood and Feelings Questionnaire (MFQ) with a benchmark score > 27) or had been recently diagnosed with depression by a medical professional. Semi-structured interviews were based on conceptual model drawings created by participants and analyzed using thematic analysis. RESULTS Four main themes emerged: 1) Depression secrecy: positive and negative aspects; 2) Depression disclosure: positive and negative aspects; 3) The solution is selective disclosure; and 4) Participants' recommendations do not align with personal preferences. In particular, the young people described non-disclosure as a way to be in control, but that secrecy prevented authentic engagement with others. Young people also described disclosure as eliciting more stigma but as necessary to gain help. Finally, the young people described struggling with knowing how much to disclose in relation to their mental health and with whom they could disclose. CONCLUSIONS This study provides new evidence of how young people with depression experience stigma and its effects on disclosure and mental health secrecy. Knowing how young people struggle with these issues can allow us to develop interventions to encourage them to come forward and discuss their mental health in order to receive appropriate support and treatment. We recommend young people be signposted and have access to mental health champions or nominated teachers in their schools or universities.
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Affiliation(s)
- Katie Prizeman
- Department of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Ciara McCabe
- Department of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Netta Weinstein
- Department of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
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9
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LaMontagne AD, Too L, Witt K, Evans‐Whipp T, Owen PJ, Toumbourou JW. Does adolescent depression modify the association between psychosocial job stressors and mental health in emergent adulthood? Am J Ind Med 2024; 67:44-54. [PMID: 37924234 PMCID: PMC10952472 DOI: 10.1002/ajim.23547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 10/17/2023] [Accepted: 10/19/2023] [Indexed: 11/06/2023]
Abstract
BACKGROUND Job stressors can be particularly harmful to the mental health of disadvantaged groups through differential exposure, differential sensitivity to the effects of exposure, or both. In this paper, we assess the extent to which emergent adult workers with an adolescent history of high depression symptoms may be differentially sensitive to the effect of job stressors on mental health. METHODS We conducted a secondary analysis of three waves of the Australian arm of the International Youth Development Study (n = 1262). We used multivariable linear regression to assess whether self-reported measures of high depression symptoms at one or two time points in adolescence (ages 11-16 years) modified the cross-sectional association between four self-reported job stressors (job demands, job control, job strain, and incivility at work) and psychological distress (Kessler-10 scores) in emergent adulthood (ages 23-27 years). RESULTS For all four job stressors, there was a consistent pattern of approximately a doubling in the magnitude of association for participants with a history of high depression symptoms at two points in adolescence compared with those with no history of depression. However, results of effect modification analysisfor only job demands and job strain excluded chance as a potential explanation. CONCLUSIONS Findings showed partial support for the hypothesis that a history of high depression symptoms in adolescence predicts stronger associations between job stressor exposures and psychological distress among those employed in emergent adulthood. The limitations of this secondary analysis suggest a need for purpose-designed studies to answer this important research question more definitively.
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Affiliation(s)
- Anthony D. LaMontagne
- Institute for Health TransformationDeakin UniversityGeelongVictoriaAustralia
- Melbourne School of Global & Population HealthUniversity of MelbourneMelbourneVictoriaAustralia
| | - Lay‐San Too
- Melbourne School of Global & Population HealthUniversity of MelbourneMelbourneVictoriaAustralia
| | - Katrina Witt
- Centre for Youth Mental HealthThe University of MelbourneMelbourneVictoriaAustralia
- OrygenParkvilleVictoriaAustralia
| | - Tracy Evans‐Whipp
- Australian Institute of Family StudiesSouthbankVictoriaAustralia
- Department of PaediatricsThe University of MelbourneMelbourneVictoriaAustralia
| | - Patrick J. Owen
- Institute for Health TransformationDeakin UniversityGeelongVictoriaAustralia
| | - John W. Toumbourou
- Centre for Social and Early Emotional Development (SEED)Deakin UniversityGeelongVictoriaAustralia
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10
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Rautio D, Andrén P, Gumpert M, Jolstedt M, Jassi A, Krebs G, Jansson-Fröjmark M, Lundgren T, Serlachius E, Mataix-Cols D, Fernández de la Cruz L. Therapist-guided, Internet-delivered cognitive behaviour therapy for adolescents with body dysmorphic disorder: A feasibility trial with long-term follow-up. Internet Interv 2023; 34:100688. [PMID: 38034863 PMCID: PMC10685040 DOI: 10.1016/j.invent.2023.100688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 10/21/2023] [Accepted: 10/27/2023] [Indexed: 12/02/2023] Open
Abstract
Body dysmorphic disorder (BDD) is a prevalent and impairing psychiatric condition that typically debuts in adolescence and is associated with risky behaviours. The disorder can be effectively treated with cognitive behaviour therapy (CBT). However, CBT for BDD is seldom available primarily due to a shortage of trained therapists. Internet-delivered CBT (ICBT) can be a way to increase treatment availability. The aim of this feasibility trial was to evaluate the feasibility, safety, and preliminary efficacy of a CBT protocol for adolescents with BDD, adapted to be delivered over the Internet with minimal therapist support. A total of 20 participants (12-17-year-olds) meeting criteria for BDD were recruited nationally to a specialist outpatient clinic in Stockholm, Sweden. One participant withdrew consent and their data could not be analysed. Nineteen participants were offered 12 modules of therapist-guided ICBT for BDD and were followed up to 12 months post-treatment. Preliminary efficacy was measured at the a priori primary endpoint (3-month follow-up) and at the 12-month follow-up with the clinician-rated Yale-Brown Obsessive Compulsive Scale Modified for BDD for Adolescents. The treatment was rated as both credible and satisfactory and was associated with a large and statistically significant reduction in BDD symptom severity (d = 2.94). The proportion of participants classified as responders at the primary endpoint was 73.7%, and the proportion of full or partial remitters was 63.2%. The average therapist support time was 8 min per participant per week. Treatment gains continued to accrue up to the 12-month follow-up. Two participants attempted suicide and another two reported non-suicidal self-injuries during the study period. ICBT with minimal therapist support is a feasible, potentially efficacious, and durable treatment for adolescents with BDD. Risky behaviours typical of this patient group should be carefully monitored during treatment.
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Affiliation(s)
- Daniel Rautio
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Per Andrén
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Martina Gumpert
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Maral Jolstedt
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Amita Jassi
- National and Specialist OCD, BDD, and Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, England, United Kingdom
| | - Georgina Krebs
- National and Specialist OCD, BDD, and Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, England, United Kingdom
- University College London, Research Department of Clinical, Educational and Health Psychology, London, England, United Kingdom
| | - Markus Jansson-Fröjmark
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Tobias Lundgren
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Eva Serlachius
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Sciences, Lund University, Lund, Sweden
| | - David Mataix-Cols
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Lorena Fernández de la Cruz
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
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11
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Monzani B, Fallah D, Rautio D, Gumpert M, Jassi A, Fernández de la Cruz L, Mataix-Cols D, Krebs G. Psychometric Evaluation of the Yale-Brown Obsessive-Compulsive Scale Modified for Body Dysmorphic Disorder for Adolescents (BDD-YBOCS-A). Child Psychiatry Hum Dev 2023; 54:1799-1806. [PMID: 35678889 PMCID: PMC10582126 DOI: 10.1007/s10578-022-01376-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 05/09/2022] [Accepted: 05/12/2022] [Indexed: 11/03/2022]
Abstract
The Yale-Brown Obsessive-Compulsive Scale Modified for Body Dysmorphic Disorder for Adolescents (BDD-YBOCS-A) is a clinician-rated measure of BDD symptom severity in youth. Despite widespread use in both research and clinical practice, its psychometric properties have not been formally evaluated. The current study examined the factor structure, reliability, validity, and sensitivity to change of the BDD-YBOCS-A in 251 youths with BDD attending two specialist clinics. A principal component analysis identified two factors, explaining 56% of the variance. The scale showed good internal consistency (Cronbach's alpha = 0.87) and adequate convergent and divergent validity. In a subgroup of participants receiving BDD treatment (n = 175), BDD-YBOCS-A scores significantly decreased over time, demonstrating sensitivity to change. BDD-YBOCS-A change scores over treatment were highly correlated with severity changes measured by the Clinical Global Impression - Severity scale (r = .84). The study provides empirical support for the use of the BDD-YBOCS-A in children and adolescents with BDD.
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Affiliation(s)
- Benedetta Monzani
- National and Specialist OCD and Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, UK.
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Deanna Fallah
- National and Specialist OCD and Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, UK
| | - Daniel Rautio
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Martina Gumpert
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Amita Jassi
- National and Specialist OCD and Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, UK
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Lorena Fernández de la Cruz
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - David Mataix-Cols
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Georgina Krebs
- National and Specialist OCD and Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, UK
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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12
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Prizeman K, Weinstein N, McCabe C. Effects of mental health stigma on loneliness, social isolation, and relationships in young people with depression symptoms. BMC Psychiatry 2023; 23:527. [PMID: 37479975 PMCID: PMC10362624 DOI: 10.1186/s12888-023-04991-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 06/30/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is the most prevalent affective disorder and the leading cause of illness and disability among young people worldwide. Besides being more susceptible to the onset of depression, young people have a higher risk of loneliness, and their personal and social development is impacted by social relationships during this time. It is thought that mental health stigma can undermine both help-seeking and longer-term outcomes for disorders like depression in young people. However, how stigma (i.e., related to depression) might affect young people's feelings of loneliness, social isolation, and relationships is unclear. Using qualitative research methods, this study aimed to explore the subjective experiences of public and internalized stigma and its effects on loneliness, social isolation, and relationship quality in young people with depression symptoms. METHODS We carried out in-depth, semi-structured interviews with N = 22 young people aged 17-25 (Mage = 22 years) who reported high symptoms of depression (Mood and Feelings Questionnaire (MFQ) score > 27) (i.e., community sample, N = 9) or had been previously diagnosed with depression by a medical professional (i.e., clinical sample, N = 13). Data were analysed using thematic analysis. We explored the subjective effects of depression stigma on loneliness, social isolation, and relationships. RESULTS Participants described both public stigma (i.e., initiated by others) and internalized stigma (i.e., self-imposed) as disrupting social relationships and eliciting loneliness, isolation, and depressive symptomology. Four main themes about young people's subjective experiences of stigma were identified: 1) Others' Misunderstanding of Mental Health Disorders and the Impact Misunderstanding has on Relationships; 2) Effects of Stigma on the Self and Wellbeing; 3) Stigma Fosters Secrecy Versus Disclosure; and 4) Stigma Increases Loneliness Driven by Avoidance of Social Contexts. CONCLUSIONS Young people's accounts revealed a wide range of consequences beyond their depression diagnosis. Participants often felt discriminated against, misunderstood, and judged by others as a result of public stigma; they discussed internalizing these attitudes. They suggested that a lack of understanding from others, for example from their partners, family, and peers, and unreliable and/or absent support systems resulted in increased feelings of loneliness and social isolation and reduced the quality and quantity of relationship formation, social bonds, and interactions. Stigma also reduced their self-esteem and confidence, which in turn fostered secrecy and a reluctance to disclose their depression. Despite depression's stigma, most participants reported having long-term goals and aspirations to reconnect with others. These goals stood in contrast to feeling hopeless and unmotivated during periods of depression. Overall, we reveal how stigma can impact feelings of loneliness, social isolation, and relationships among young people with depression, which could lead to targeted interventions to lessen the impact of stigma in this population.
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13
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Kulikov VN, Crosthwaite PC, Hall SA, Flannery JE, Strauss GS, Vierra EM, Koepsell XL, Lake JI, Padmanabhan A. A CBT-based mobile intervention as an adjunct treatment for adolescents with symptoms of depression: a virtual randomized controlled feasibility trial. Front Digit Health 2023; 5:1062471. [PMID: 37323125 PMCID: PMC10262850 DOI: 10.3389/fdgth.2023.1062471] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 04/27/2023] [Indexed: 06/17/2023] Open
Abstract
Background High rates of adolescent depression demand for more effective, accessible treatment options. A virtual randomized controlled trial was used to assess the feasibility and acceptability of a 5-week, self-guided, cognitive behavioral therapy (CBT)-based mobile application, Spark, compared to a psychoeducational mobile application (Active Control) as an adjunct treatment for adolescents with depression during the COVID-19 pandemic. Methods A community sample aged 13-21, with self-reported symptoms of depression, was recruited nationwide. Participants were randomly assigned to use either Spark or Active Control (NSpark = 35; NActive Control = 25). Questionnaires, including the PHQ-8 measuring depression symptoms, completed before, during, and immediately following completion of the intervention, evaluated depressive symptoms, usability, engagement, and participant safety. App engagement data were also analyzed. Results 60 eligible adolescents (female = 47) were enrolled in 2 months. 35.6% of those expressing interest were consented and all enrolled. Study retention was high (85%). Spark users rated the app as usable (System Usability Scalemean = 80.67) and engaging (User Engagement Scale-Short Formmean = 3.62). Median daily use was 29%, and 23% completed all levels. There was a significant negative relationship between behavioral activations completed and change in PHQ-8. Efficacy analyses revealed a significant main effect of time, F = 40.60, p < .001, associated with decreased PHQ-8 scores over time. There was no significant Group × Time interaction (F = 0.13, p = .72) though the numeric decrease in PHQ-8 was greater for Spark (4.69 vs. 3.56). No serious adverse events or adverse device effects were reported for Spark users. Two serious adverse events reported in the Active Control group were addressed per our safety protocol. Conclusion Recruitment, enrollment, and retention rates demonstrated study feasibility by being comparable or better than other mental health apps. Spark was highly acceptable relative to published norms. The study's novel safety protocol efficiently detected and managed adverse events. The lack of significant difference in depression symptom reduction between Spark and Active Control may be explained by study design and study design factors. Procedures established during this feasibility study will be leveraged for subsequent powered clinical trials evaluating app efficacy and safety. Clinical Trial Registration https://clinicaltrials.gov/ct2/show/NCT04524598.
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Affiliation(s)
- Vera N. Kulikov
- Research Department, Limbix Health, San Francisco, CA, United States
| | | | - Shana A. Hall
- Research Department, Limbix Health, San Francisco, CA, United States
| | | | | | - Elise M. Vierra
- Content Department, Limbix Health, San Francisco, CA, United States
| | - Xin L. Koepsell
- Content Department, Limbix Health, San Francisco, CA, United States
| | - Jessica I. Lake
- Science Department, Limbix Health, San Francisco, CA, United States
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14
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Walter HJ, Abright AR, Bukstein OG, Diamond J, Keable H, Ripperger-Suhler J, Rockhill C. Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents With Major and Persistent Depressive Disorders. J Am Acad Child Adolesc Psychiatry 2023; 62:479-502. [PMID: 36273673 DOI: 10.1016/j.jaac.2022.10.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 10/14/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To enhance the quality of care and clinical outcomes for children and adolescents with major depressive disorder (MDD) and persistent depressive disorder (PDD). The aims are as follows: (1) to summarize empirically based guidance about the psychosocial and psychopharmacologic treatment of MDD and PDD in children and adolescents; and (2) to summarize expert-based guidance about the assessment of these disorders as an integral part of treatment, and the implementation of empirically based treatments for these disorders in clinical practice. METHOD Statements about the treatment of MDD and PDD are based upon empirical evidence derived from a critical systematic review of the scientific literature conducted by the Research Triangle Institute International-University of North Carolina at Chapel Hill (RTI-UNC) Evidence-based Practice Center under contract with the Agency for Healthcare Research and Quality (AHRQ). Evidence from meta-analyses published since the AHRQ/RTI-UNC review is also presented to support or refute the AHRQ findings. Guidance about the assessment and clinical implementation of treatments for MDD and PDD is informed by expert opinion and consensus as presented in previously published clinical practice guidelines, chapters in leading textbooks of child and adolescent psychiatry, the DSM-5-TR, and government-affiliated prescription drug information websites. RESULTS Psychotherapy (specifically, cognitive-behavioral and interpersonal therapies) and selective serotonin reuptake inhibitor (SSRI) medication have some rigorous (randomized controlled trials, meta-analyses) empirical support as treatment options. Because effective treatment outcomes are predicated in part upon accuracy of the diagnosis, depth of the clinical formulation, and breadth of the treatment plan, comprehensive, evidence-based assessment may enhance evidence-based treatment outcomes. CONCLUSION Disproportionate to the magnitude of the problem, there are significant limitations in the quality and quantity of rigorous empirical support for the etiology, assessment, and treatment of depression in children and adolescents. In the context of a protracted severe shortage of child and adolescent-trained behavioral health specialists, the demonstration of convenient, efficient, cost-effective, and user-friendly delivery mechanisms for safe and effective treatment of MDD and PDD is a key research need. Other research priorities include the sequencing and comparative effectiveness of depression treatments, delineation of treatment mediators and moderators, effective approaches to treatment nonresponders and disorder relapse/recurrence, long-term effects and degree of suicide risk with SSRI use, and the discovery of novel pharmacologic or interventional treatments.
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15
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Greene CA, McCoach DB, Ford JD, McCarthy K, Randall KG, Lang JM. Bidirectional effects of parental and adolescent symptom change in trauma-focused cognitive behavioral therapy. Psychol Trauma 2023; 15:S172-S182. [PMID: 36848057 PMCID: PMC10214389 DOI: 10.1037/tra0001445] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
OBJECTIVE The current study examines dynamic, bidirectional associations between parent and adolescent symptom improvement in response to children's therapy for posttraumatic stress disorder (PTSD). METHOD Data were collected from a racially and ethnically heterogeneous sample of 1,807 adolescents (age 13-18 years old; 69% female) and a parent participating in Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) at a community outpatient behavioral health clinic. Parents self-reported their depressive symptoms and youth self-reported their PTSD and depressive symptoms at the onset of treatment and every three months for up to nine months. Using a bivariate dual change score model (BDCSM) we examine: (a) individual dyad members' change in symptoms and (b) the bidirectional associations between changes in the parent's and youth's symptoms across treatment. RESULTS Parents' and adolescents' symptoms at the start of treatment were correlated and both parents' and adolescents' symptoms decreased over the course of treatment. Parents' elevated depressive symptoms at each time point contributed to smaller decreases in their children's PTSD and depressive symptoms at the subsequent time point. Adolescents' elevated symptoms at each time point contributed to greater decreases in their parents' symptoms at the subsequent time point. CONCLUSIONS These findings highlight the impact that parents and children have on each other's response to children's trauma-focused psychotherapy. Notably, parents' depressive symptoms appeared to slow their children's progress in treatment, suggesting that attending to parents' symptoms and providing them with supportive services may be an important adjunct to children's interventions. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Carolyn A. Greene
- Department of Psychiatry, University of Connecticut School of Medicine
| | | | - Julian D. Ford
- Department of Psychiatry, University of Connecticut School of Medicine
| | - Kimberly McCarthy
- Department of Psychiatry, University of Connecticut School of Medicine
| | | | - Jason M. Lang
- Department of Psychiatry, University of Connecticut School of Medicine
- Child Health and Development Institute of Connecticut, Inc
- Child Study Center, Yale School of Medicine
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16
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Grammer AC, Best JR, Fowler LA, Stein RI, Conlon RPK, Balantekin KN, Welch RR, Perri MG, Epstein LH, Wilfley DE. Change in parent and child psychopathology following obesity treatment and maintenance: A secondary data analysis. Pediatr Obes 2023; 18:e12971. [PMID: 35971859 PMCID: PMC9772295 DOI: 10.1111/ijpo.12971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 07/11/2022] [Accepted: 08/01/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND General and eating disorder (ED) psychopathology are common among children and adults with overweight/obesity; few studies have examined their course of change throughout family-based behavioural obesity treatment (FBT) and maintenance. OBJECTIVES Examine: (1) the changes in the parent and child general and ED psychopathology during FBT and maintenance interventions; (2) the associations between change in psychopathology and change in weight among children or parents; (3) the associations between change in psychopathology within parent-child dyads. METHODS 172 parent-child dyads participated in 4-month FBT and were subsequently randomized to one of three 8-month maintenance interventions. General psychopathology (child anxiety/depressive symptoms, parent severity of global psychological distress), ED psychopathology (shape/weight concern), and percent overweight were assessed at baseline, post-FBT, and post-maintenance. Separate linear mixed-effects models evaluated change in general and ED psychopathology, including an interaction between maintenance condition and time. Partial correlations examined associations between change in psychopathology and percent overweight among children or parents, and associations between change in psychopathology within parent-child dyads. RESULTS Among children, significant reductions were observed from baseline to post-FBT in all forms of psychopathology and from post-FBT to post-maintenance in general psychopathology. Among parents, significant reductions were observed from baseline to post-FBT in all forms of psychopathology; reductions were maintained from post-FBT to post-maintenance. There was no significant interaction between maintenance condition and time. Correlations between change in most forms of parent or child psychopathology and percent overweight were observed. CONCLUSIONS Participation in FBT and maintenance was associated with improvements in general and ED psychopathology in both parents and children.
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Affiliation(s)
- Anne Claire Grammer
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - John R. Best
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Lauren A. Fowler
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Richard I. Stein
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Rachel P. Kolko Conlon
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Katherine N. Balantekin
- Department of Exercise and Nutrition Sciences, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
| | - R. Robinson Welch
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Michael G. Perri
- Department of Clinical & Health Psychology, University of Florida, Gainesville, Florida, USA
| | - Leonard H. Epstein
- Division of Behavioral Medicine, Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
| | - Denise E. Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
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17
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Mundy LK, Canterford L, Moreno-Betancur M, Hoq M, Viner RM, Bayer JK, Lietz P, Redmond G, Patton GC. Learning outcomes in primary school children with emotional problems: a prospective cohort study. Child Adolesc Ment Health 2022. [PMID: 36400427 DOI: 10.1111/camh.12607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/30/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Academic difficulties are common in adolescents with mental health problems. Although earlier childhood emotional problems, characterised by heightened anxiety and depressive symptoms are common forerunners to adolescent mental health problems, the degree to which mental health problems in childhood may contribute independently to academic difficulties has been little explored. METHODS Data were drawn from a prospective cohort study of students in Melbourne, Australia (N = 1239). Data were linked with a standardised national assessment of academic performance at baseline (9 years) and wave three (11 years). Depressive and anxiety symptoms were assessed at baseline and wave two (10 years). Regression analyses estimated the association between emotional problems (9 and/or 10 years) and academic performance at 11 years, adjusting for baseline academic performance, sex, age and socioeconomic status, and hyperactivity/inattention symptoms. RESULTS Students with depressive symptoms at 9 years of age had lost nearly 4 months of numeracy learning two years later after controlling for baseline academic performance and confounders. Results were similar for anxiety symptoms. Regardless of when depressive symptoms occurred there were consistent associations with poorer numeracy performance at 11 years. The association of depressive symptoms with reading performance was weaker than for numeracy if they were present at wave two. Persistent anxiety symptoms across two waves led to nearly a 4 month loss of numeracy learning at 11 years, but the difference was not meaningful for reading. Findings were similar when including hyperactivity/inattention symptoms. CONCLUSIONS Childhood anxiety and depression are not only forerunners of later mental health problems but predict academic achievement. Partnerships between education and health systems have the potential to not only improve childhood emotional problems but also improve learning.
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Affiliation(s)
- Lisa K Mundy
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | | | - Margarita Moreno-Betancur
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Monsurul Hoq
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Russell M Viner
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - Jordana K Bayer
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia.,School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia
| | - Petra Lietz
- Australian Council for Educational Research, Adelaide, SA, Australia
| | - Gerry Redmond
- College of Business, Government and Law, Flinders University, Bedford Park, SA, Australia
| | - George C Patton
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
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Rautio D, Gumpert M, Jassi A, Krebs G, Flygare O, Andrén P, Monzani B, Peile L, Jansson-Fröjmark M, Lundgren T, Hillborg M, Silverberg-Mörse M, Clark B, Fernández de la Cruz L, Mataix-Cols D. Effectiveness of Multimodal Treatment for Young People With Body Dysmorphic Disorder in Two Specialist Clinics. Behav Ther 2022; 53:1037-1049. [PMID: 35987534 DOI: 10.1016/j.beth.2022.04.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 04/19/2022] [Accepted: 04/22/2022] [Indexed: 11/24/2022]
Abstract
Body dysmorphic disorder (BDD) typically originates in adolescence and is associated with considerable adversity. Evidence-based treatments exist but research on clinical outcomes in naturalistic settings is extremely scarce. We evaluated the short- and long-term outcomes of a large cohort of adolescents with BDD receiving specialist multimodal treatment and examined predictors of symptom improvement. We followed 140 young people (age range 10-18) with a diagnosis of BDD treated at two national and specialist outpatient clinics in Stockholm, Sweden (n = 96) and London, England (n = 44), between January 2015 and April 2021. Participants received multimodal treatment consisting of cognitive behavior therapy and, in 72% of cases, medication (primarily selective serotonin reuptake inhibitors). Data were collected at baseline, posttreatment, and 3, 6, and 12 months after treatment.The primary outcome measure was the clinician-rated Yale-Brown Obsessive-Compulsive Scale Modified for BDD, Adolescent version (BDD-YBOCS-A). Secondary outcomes included self-reported measures of BDD symptoms, depressive symptoms, and global functioning. Mixed-effects regression models showed that BDD-YBOCS-A scores decreased significantly from baseline to posttreatment (coefficient [95% confidence interval] = -16.33 [-17.90 to -14.76], p<0.001; within-group effect size (Cohen's d) = 2.08 (95% confidence interval, 1.81 to 2.35). At the end of the treatment, 79% of the participants were classified as responders and 59% as full or partial remitters. BDD symptoms continued to improve throughout the follow-up. Improvement was also seen on all secondary outcome measures. Linear regression models identified baseline BDD symptom severity as a predictor of treatment outcome at posttreatment, but no consistent predictors were found at the 12-month follow-up. To conclude, multimodal treatment for adolescent BDD is effective in both the short- and long-term when provided flexibly within a specialist setting. Considering the high personal and societal costs of BDD, specialist care should be made more widely available.
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Affiliation(s)
- Daniel Rautio
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet; Stockholm Health Care Services, Region Stockholm.
| | - Martina Gumpert
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet; Stockholm Health Care Services, Region Stockholm
| | - Amita Jassi
- National and Specialist OCD, BDD, and Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust
| | - Georgina Krebs
- Department of Clinical, Educational and Health Psychology, University College London
| | - Oskar Flygare
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet; Stockholm Health Care Services, Region Stockholm
| | - Per Andrén
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet; Stockholm Health Care Services, Region Stockholm
| | - Benedetta Monzani
- National and Specialist OCD, BDD, and Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust
| | - Lauren Peile
- National and Specialist OCD, BDD, and Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust
| | - Markus Jansson-Fröjmark
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet; Stockholm Health Care Services, Region Stockholm
| | - Tobias Lundgren
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet; Stockholm Health Care Services, Region Stockholm
| | | | | | - Bruce Clark
- National and Specialist OCD, BDD, and Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust
| | - Lorena Fernández de la Cruz
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet; Stockholm Health Care Services, Region Stockholm
| | - David Mataix-Cols
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet; Stockholm Health Care Services, Region Stockholm
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19
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Handakas E, Xu Y, Segal AB, Huerta MC, Bowman K, Howe LD, Sassi F, Robinson O. Molecular mediators of the association between child obesity and mental health. Front Genet 2022; 13:947591. [PMID: 36118877 PMCID: PMC9473726 DOI: 10.3389/fgene.2022.947591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 07/27/2022] [Indexed: 11/24/2022] Open
Abstract
Biological mechanisms underlying the association between obesity and depression remain unclear. We investigated the role of metabolites and DNA methylation as mediators of the relationship between childhood obesity and subsequent poor mental health in the English Avon Longitudinal Study of Parents and Children. Obesity was defined according to United Kingdom Growth charts at age 7 years and mental health through the Short Mood and Feelings Questionnaire (SMFQ) completed at age 11 years. Metabolites and DNA methylation were measured by nuclear magnetic resonance spectroscopy and Illumina array in blood at the age of 7 years. The associations between obesity and SMFQ score, as continuous count data or using cut-offs to define depressive symptoms (SMFQ >7) or depression (SMFQ >11), were tested using adjusted Poisson and logistic regression. Candidate metabolite mediators were identified through metabolome-wide association scans for obesity and SMFQ score, correcting for false-discovery rate. Candidate DNA methylation mediators were identified through testing the association of putative BMI-associated CpG sites with SMFQ scores, correcting for look-up false-discovery rate. Mediation by candidate molecular markers was tested. Two-sample Mendelian randomization (MR) analyses were additionally applied to test causal associations of metabolites with depression in independent adult samples. 4,018 and 768 children were included for metabolomics and epigenetics analyses, respectively. Obesity at 7 years was associated with a 14% increase in SMFQ score (95% CI: 1.04, 1.25) and greater odds of depression (OR: 1.46 (95% CI: 0.78, 2.38) at 11 years. Natural indirect effects (mediating pathways) between obesity and depression for tyrosine, leucine and conjugated linoleic acid were 1.06 (95% CI: 1.00, 1.13, proportion mediated (PM): 15%), 1.04 (95% CI: 0.99, 1.10, PM: 9.6%) and 1.06 (95% CI: 1.00, 1.12, PM: 13.9%) respectively. In MR analysis, one unit increase in tyrosine was associated with 0.13 higher log odds of depression (p = 0.1). Methylation at cg17128312, located in the FBXW9 gene, had a natural indirect effect of 1.05 (95% CI: 1.01,1.13, PM: 27%) as a mediator of obesity and SMFQ score. Potential biologically plausible mechanisms involving these identified molecular features include neurotransmitter regulation, inflammation, and gut microbiome modulation. These results require replication in further observational and mechanistic studies.
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Affiliation(s)
- Evangelos Handakas
- Μedical Research Council Centre for Environment and Health, Imperial College London, London, United Kingdom
| | - Yiwen Xu
- Centre for Health Economics and Policy Innovation, Department of Economics and Public Policy, Imperial College Business School, London, United Kingdom
| | - Alexa Blair Segal
- Centre for Health Economics and Policy Innovation, Department of Economics and Public Policy, Imperial College Business School, London, United Kingdom
| | - Maria Carmen Huerta
- Centre for Health Economics and Policy Innovation, Department of Economics and Public Policy, Imperial College Business School, London, United Kingdom
| | - Kirsty Bowman
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
- Population Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Laura D. Howe
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
- Population Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Franco Sassi
- Centre for Health Economics and Policy Innovation, Department of Economics and Public Policy, Imperial College Business School, London, United Kingdom
| | - Oliver Robinson
- Μedical Research Council Centre for Environment and Health, Imperial College London, London, United Kingdom
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20
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Cooley JL, Mitchell TB, Pastrana FA, Hanson RF. Trauma-Focused CBT in the Context of Parental Chronic Medical Conditions: A Case Report. Cognitive and Behavioral Practice 2022; 29:682-97. [DOI: 10.1016/j.cbpra.2021.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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21
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Espeleta HC, Peer SO, Are F, Hanson RF. Therapists' Perceived Competence in Trauma-Focused Cognitive Behavioral Therapy and Client Outcomes: Findings From a Community-Based Learning Collaborative. Child Maltreat 2022; 27:455-465. [PMID: 33783257 DOI: 10.1177/10775595211003673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This study examined therapists' perceived competence in Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and its association with youth treatment outcomes (posttraumatic stress and depression). Participants included 99 community therapists enrolled in a TF-CBT-focused Learning Collaborative (LC), along with one of their randomly selected TF-CBT training cases. Analyzed data included: 1) caregiver/youth-reported posttraumatic stress and depressive symptoms, pre- and post-treatment, and 2) therapist-perceived competence with TF-CBT components across treatment delivery. Youth- and caregiver-reports indicated large, significant pre- to post-treatment decreases in youth posttraumatic stress (ds = 1.10-1.30, ps < .001) and depressive symptoms (d = 1.01, p < .001). Higher therapist-perceived competence with TF-CBT predicted positive treatment responses for posttraumatic stress (ds = 0.38-0.39, ps = .03) and depression (d = 0.25), though only the former association was significant (ps = .03 vs. p = .15). Findings highlight the need to monitor and improve therapists' competencies to enhance clinical outcomes for trauma-exposed youth and suggest that LCs may be an effective training/implementation model to help achieve those critical goals.
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Affiliation(s)
- Hannah C Espeleta
- College of Nursing, 15895Medical University of South Carolina, Charleston, SC, USA
| | - Samuel O Peer
- Department of Psychology, 6640Idaho State University, Pocatello, ID, USA
| | - Funlola Are
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Rochelle F Hanson
- Institute of Psychiatry, 2345Medical University of South Carolina, Charleston, SC, USA
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22
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Kulik L. A multi-variable model for explaining long-term commitment to volunteering among COVID-19 volunteers. Anal Soc Issues Public Policy 2022; 22:ASAP12322. [PMID: 36042820 PMCID: PMC9413336 DOI: 10.1111/asap.12322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 06/23/2022] [Accepted: 06/24/2022] [Indexed: 06/15/2023]
Abstract
The aim of the study was to test variables that explain long-term commitment to volunteering among volunteers in the first wave of the COVID-19 pandemic in Israel. Long-term commitment to volunteering was tested by the participants' evaluation of the stability, consistency, and intensity of their volunteering over time. Two theoretical frameworks served for explaining commitment to volunteering: the social-structural approach and the psychological characteristics approach. The sample was comprised of 504 Jewish participants: 173 men and 331 women. The data were collected via structured questionnaires distributed by nonprofit volunteer organizations. The most significant contribution to explaining long-term commitment to volunteering, in all its forms, was for psychological characteristics reflected in emotions during the pandemic and in the motives for volunteering, the volunteer's gender, level of education, and tendency to volunteer during routine times. Volunteer organizations should focus on cultivating a large and motivated population of volunteers to maintain long-term volunteering during emergencies and in routine times.
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Affiliation(s)
- Liat Kulik
- School of Social WorkBar‐Ilan UniversityRamat‐GanIsrael
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23
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Bashford‐Largo J, Zhang R, Mathur A, Elowsky J, Schwartz A, Dobbertin M, Blair RJR, Blair KS, Bajaj S. Reduced cortical volume of the default mode network in adolescents with generalized anxiety disorder. Depress Anxiety 2022; 39:485-495. [PMID: 35312127 PMCID: PMC9246827 DOI: 10.1002/da.23252] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 03/03/2022] [Accepted: 03/06/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Widespread structural alterations have been shown to be implicated in individuals with generalized anxiety disorder (GAD). However, there have been inconsistent findings in cortical volume (CV) differences. Most structural neuroimaging studies looking at GAD used region-based approach with relatively small sample sizes, let alone be specific to adolescents with GAD. We believe this is the first study to look at CV measures using a network-based approach in a larger sample of adolescents with GAD. The goal of the current study was to focus on three different brain networks (i.e., Limbic, Frontoparietal, and Default Mode Network [DMN]) in adolescents with GAD. METHOD The study involved 81 adolescents with GAD and 112 typically developing (TD) comparison individuals matched on age (15.98 and 15.63 respective means), sex (42F/39M and 45F/67M), and IQ (101.90 and 103.94 respective means). Participants underwent structural MRI. Freesurfer was used to estimate CV (both network-specific and region-specific within networks) and region-specific sub-cortical volume measures. Multivariate analysis of covariance (MANCOVA; with sex, age, IQ, and intracranial volume [ICV] as potential covariates) was used to estimate group differences. RESULTS We found significantly lower CV for the DMN in adolescents with GAD, compared with TD individuals. Adolescents with GAD also showed significantly lower hemispheric mean CV of the default-mode regions (particularly the prefrontal and temporal regions) and the hippocampus, compared with TD individuals. CONCLUSION The current findings suggest structural alterations in adolescents with GAD. These structural alterations will need to be addressed when implementing and developing treatments for patients with GAD.
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Affiliation(s)
- Johannah Bashford‐Largo
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral ResearchBoys Town National Research HospitalBoys TownNebraskaUSA,Center for Brain, Biology, and BehaviorUniversity of Nebraska‐LincolnLincolnNebraskaUSA
| | - Ru Zhang
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral ResearchBoys Town National Research HospitalBoys TownNebraskaUSA
| | - Avantika Mathur
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral ResearchBoys Town National Research HospitalBoys TownNebraskaUSA
| | - Jaimie Elowsky
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral ResearchBoys Town National Research HospitalBoys TownNebraskaUSA
| | - Amanda Schwartz
- Department of PsychologyUniversity of North DakotaGrand ForksNorth DakotaUSA
| | - Matthew Dobbertin
- Inpatient Psychiatric Care UnitBoys Town National Research HospitalBoys TownNebraskaUSA
| | - Robert James R. Blair
- Child and Adolescent Mental Health Centre, Mental Health ServicesCapital Region of DenmarkCopenhagenDenmark
| | - Karina S. Blair
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral ResearchBoys Town National Research HospitalBoys TownNebraskaUSA
| | - Sahil Bajaj
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral ResearchBoys Town National Research HospitalBoys TownNebraskaUSA
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24
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Rautio D, Jassi A, Krebs G, Andrén P, Monzani B, Gumpert M, Lewis A, Peile L, Sevilla-Cermeño L, Jansson-Fröjmark M, Lundgren T, Hillborg M, Silverberg-Morse M, Clark B, Fernández de la Cruz L, Mataix-Cols D. Clinical characteristics of 172 children and adolescents with body dysmorphic disorder. Eur Child Adolesc Psychiatry 2022; 31:133-144. [PMID: 33165651 PMCID: PMC8817062 DOI: 10.1007/s00787-020-01677-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 10/25/2020] [Indexed: 11/06/2022]
Abstract
Body dysmorphic disorder (BDD) often starts in childhood, with most cases developing symptoms before age 18. Yet, BDD research has primarily focused on adults. We report the clinical characteristics of the world's largest cohort of carefully diagnosed youths with BDD and focus on previously unexplored sex and age differences. We systematically collected clinical data from 172 young people with BDD consecutively referred to 2 specialist pediatric obsessive-compulsive and related disorders outpatient clinics in Stockholm, Sweden and in London, England. A series of clinician-, self-, and parent-reported measures were administered. The cohort consisted of 136 girls, 32 boys, and 4 transgender individuals (age range 10-19 years). The mean severity of BDD symptoms was in the moderate to severe range, with more than one third presenting with severe symptoms and more than half showing poor or absent insight/delusional beliefs. We observed high rates of current psychiatric comorbidity (71.5%), past or current self-harm (52.1%), suicide attempts (11.0%), current desire for cosmetic procedures (53.7%), and complete school dropout (32.4%). Compared to boys, girls had significantly more severe self-reported BDD symptoms, depression, suicidal thoughts, and self-harm. Compared to the younger participants (14 or younger), older participants had significantly more severe compulsions and were more likely to report a desire for conducting cosmetic procedures. Adolescent BDD can be a severe and disabling disorder associated with significant risks and substantial functional impairment. The clinical presentation of the disorder is largely similar across sexes and age groups, indicating the importance of early detection and treatment. More research is needed specifically focusing on boys and pre-pubertal individuals with BDD.
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Affiliation(s)
- Daniel Rautio
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Gävlegatan 22 (Entré B), floor 8, 113 30, Stockholm, Sweden.
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
| | - Amita Jassi
- National and Specialist OCD, BDD, and Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, UK
| | - Georgina Krebs
- National and Specialist OCD, BDD, and Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, UK
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK
| | - Per Andrén
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Gävlegatan 22 (Entré B), floor 8, 113 30, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Benedetta Monzani
- National and Specialist OCD, BDD, and Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, UK
| | - Martina Gumpert
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Gävlegatan 22 (Entré B), floor 8, 113 30, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Angela Lewis
- National and Specialist OCD, BDD, and Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, UK
| | - Lauren Peile
- National and Specialist OCD, BDD, and Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, UK
| | - Laura Sevilla-Cermeño
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Gävlegatan 22 (Entré B), floor 8, 113 30, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Departamento de Medicina y Especialidades Médicas, Universidad de Alcalá, Madrid, Spain
| | - Markus Jansson-Fröjmark
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Gävlegatan 22 (Entré B), floor 8, 113 30, Stockholm, Sweden
| | - Tobias Lundgren
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Gävlegatan 22 (Entré B), floor 8, 113 30, Stockholm, Sweden
| | - Maria Hillborg
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | | | - Bruce Clark
- National and Specialist OCD, BDD, and Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, UK
| | - Lorena Fernández de la Cruz
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Gävlegatan 22 (Entré B), floor 8, 113 30, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - David Mataix-Cols
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Gävlegatan 22 (Entré B), floor 8, 113 30, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
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25
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Pedersen ML, Jozefiak T, Sund AM, Holen S, Neumer SP, Martinsen KD, Rasmussen LMP, Patras J, Lydersen S. Psychometric properties of the Brief Problem Monitor (BPM) in children with internalizing symptoms: examining baseline data from a national randomized controlled intervention study. BMC Psychol 2021; 9:185. [PMID: 34838153 PMCID: PMC8626919 DOI: 10.1186/s40359-021-00689-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 11/16/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Prevention is essential to reduce the development of symptomology among children and adolescents into disorders, thereby improving public health and reducing costs. Therefore, easily administered screening and early assessment methods with good reliability and validity are necessary to effectively identify children's functioning and how these develop. The Brief Problem Monitor (BPM) is an instrument designed for this purpose. This study examined the psychometric properties of the Norwegian version of the BPM parent (BPM-P) and teacher (BPM-T) versions, including internal reliability and construct validity at assessing children with internalizing problems. METHODS Baseline data were collected from a national randomized controlled intervention study. Children aged 8-12 years with self-reported symptoms of anxiety and/or depression with one standard deviation above a chosen population's mean were included in this study. Teachers (n = 750) and parents (n = 596) rated children using the BPM-T and BPM-P, respectively. Internal consistency was measured using Cronbach's alpha, and multi-informant agreement between the BPM-P and BPM-T was measured using Spearman's correlations. Construct validity was assessed via confirmatory factor analysis. RESULTS Internal consistency was good throughout all domains for both the BPM-P and BPM-T, with a Cronbach's alpha ranging from .763 to .878. Multi-informant agreement between the parents and the teacher was moderate on the externalizing, attention, and total scales and low on the internalizing scale. The model fit for the three-factor structure of the BPM was excellent for the BPM-P and good for the BPM-T. CONCLUSIONS Internal consistency was good, and the original three-factor solution of the BPM-P and BPM-T was confirmed based on our sample of school children at-risk for emotional problems. These promising results indicate that the BPM may be a valid short assessment tool for measuring attentional, behavioral, and internalizing problems in children. Trial registration in Clinical Trials: NCT02340637; June 12, 2014.
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Affiliation(s)
- Marit Løtveit Pedersen
- Regional Center for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Thomas Jozefiak
- Regional Center for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Anne Mari Sund
- Regional Center for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Child and Adolescent Psychiatry, St. Olavs University Hospital, Trondheim, Norway
| | - Solveig Holen
- Centre for Child and Adolescent Mental Health, RBUP East and South, Oslo, Norway
| | - Simon-Peter Neumer
- Centre for Child and Adolescent Mental Health, RBUP East and South, Oslo, Norway
| | - Kristin D. Martinsen
- Centre for Child and Adolescent Mental Health, RBUP East and South, Oslo, Norway
| | - Lene Mari P. Rasmussen
- RKBU – North, Health Sciences Faculty, UiT The Arctic University of Norway, Tromsø, Norway
| | - Joshua Patras
- RKBU – North, Health Sciences Faculty, UiT The Arctic University of Norway, Tromsø, Norway
| | - Stian Lydersen
- Regional Center for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
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26
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Talja T, Rantanen A, Koivisto AM, Fröjd S, Ikonen R, Joronen K. Early identification of depressive symptoms in school-aged children: Psychometric properties and validation of a new short version of Short Mood & Feelings Questionnaire. Scand J Caring Sci 2021; 36:393-403. [PMID: 34739150 DOI: 10.1111/scs.13042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 08/12/2021] [Accepted: 10/17/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND Depressive mood is a common problem among children in Western countries. Professionals in school and other health services have an important role in identifying children at increased risk for depression. The Short Mood and Feelings Questionnaire (SMFQ) is a widely used screening tool, but its 13 items still make it quite time-consuming to complete. There is an urgent need for a quick and easy-to-complete self-report depressive mood scale for use in school health examinations. AIM This paper aims to describe and validate a revised version of SMFQ: FsMFQ-6 is intended as a short screening tool for the early identification of depressive symptoms in children. METHODS Nationally representative data (n = 95,725) were drawn from the 2017 School Health Promotion Study. The respondents were fourth- and fifth-grade pupils (aged 10-12) in Finnish primary schools. The data were analysed separately by gender. The construct validity of the scale was studied by principal component analysis and confirmatory factor analysis (CFA), convergent validity by both receiver operating characteristic (ROC) analysis and Spearman's correlation coefficient. Reliability was tested by Cronbach's alpha coefficient. RESULTS Principal component analysis yielded a one-component model: the Finnish Short Mood and Feelings Questionnaire 6 (FsMFQ-6). CFA confirmed the validity of FsMFQ-6. Compared with mood at home (AUC = 0.80) and mood at school (AUC = 0.85), overall sensitivity and specificity were optimal at cut-off point 0. Cronbach's alpha coefficient was 0.73, indicating good internal consistency. The results for girls and boys were almost identical. CONCLUSION The results confirmed the validity and reliability of FsMFQ-6. FsMFQ-6 recognises depressive mood in children and is suitable for screening depressive symptoms in fourth- and fifth-grade pupils in Finland. However, it is important to pay close attention to children who choose the 'Sometimes' response option more than once, for that can be a sign of depressive symptoms.
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Affiliation(s)
- Tiina Talja
- Health Sciences, Nursing Science, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Anja Rantanen
- Health Sciences, Nursing Science, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Anna-Maija Koivisto
- Health Sciences, Biostatistics, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Sari Fröjd
- Health Sciences, Social Psychiatry, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Riikka Ikonen
- Health Sciences, Nursing Science, Faculty of Social Sciences, Tampere University, Tampere, Finland.,Government services, Competence cluster for violence prevention work, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Katja Joronen
- Department of Nursing Science, University of Turku, Turku, Finland
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Eyre O, Bevan Jones R, Agha SS, Wootton RE, Thapar AK, Stergiakouli E, Langley K, Collishaw S, Thapar A, Riglin L. Validation of the short Mood and Feelings Questionnaire in young adulthood. J Affect Disord 2021; 294:883-888. [PMID: 34375216 PMCID: PMC8411664 DOI: 10.1016/j.jad.2021.07.090] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 04/30/2021] [Accepted: 07/11/2021] [Indexed: 02/09/2023]
Abstract
Depression often onsets in adolescence and is associated with recurrence in adulthood. There is a need to identify and monitor depression symptoms across adolescence and into young adulthood. The short Mood and Feelings Questionnaire (sMFQ) is commonly used to measure depression symptoms in adolescence but has not been validated in young adulthood. This study aimed to (1) examine whether the sMFQ is valid in young adulthood, and (2) identify cut-points best capturing DSM-5 depression diagnosis at age 25 METHODS: The sample included participants in the Avon Longitudinal Study of Parents and Children (ALSPAC) at age 25 (n = 4098). Receiver Operating Characteristic analyses examined how well the self-rated sMFQ discriminates between cases and non-cases of DSM-5 Major Depressive Disorder (MDD) classified using the self-rated Development and Well Being Assessment. Sensitivity and specificity values were used to identify cut-points on the sMFQ RESULTS: The sMFQ had high accuracy for discriminating MDD cases from non-cases at age 25. The commonly used cut-point in adolescence (≥12) performed well at this age, best balancing sensitivity and specificity. However, a lower cut-point (≥10) may be appropriate when favouring sensitivity over specificity e.g., in context of screening. Sensitivity analyses suggested similar results for males and females LIMITATIONS: ALSPAC is a longitudinal population cohort that suffers from non-random attrition CONCLUSIONS: The sMFQ is a valid measure of depression in young adults in the general population. It can be used to screen for and monitor depression across adolescence and early adulthood.
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Affiliation(s)
- Olga Eyre
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Wales, United Kingdom,Cwm Taf Morgannwg University Health Board Health Board, Wales, United Kingdom
| | - Rhys Bevan Jones
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Wales, United Kingdom,Cwm Taf Morgannwg University Health Board Health Board, Wales, United Kingdom
| | - Sharifah Shameem Agha
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Wales, United Kingdom,Cwm Taf Morgannwg University Health Board Health Board, Wales, United Kingdom
| | - Robyn E Wootton
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom,Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Ajay K Thapar
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Wales, United Kingdom
| | - Evie Stergiakouli
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom,Population Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Kate Langley
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Wales, United Kingdom,School of Psychology, Cardiff University, Wales, United Kingdom
| | - Stephan Collishaw
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Wales, United Kingdom
| | - Anita Thapar
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Wales, United Kingdom
| | - Lucy Riglin
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Wales, United Kingdom.
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28
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Connelly JP, O'Connell M. Gender differences in vulnerability to maternal depression during early adolescence: Girls appear more susceptible than boys. Psychology in the Schools 2021. [DOI: 10.1002/pits.22609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- J. P. Connelly
- School of Psychology University College Dublin Dublin Ireland
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McFayden TC, Gatto AJ, Dahiya AV, Antezana L, Miyazaki Y, Cooper LD. Integrating Measurement-Based Care into Treatment for Autism Spectrum Disorder: Insights from a Community Clinic. J Autism Dev Disord 2021; 51:3651-3661. [PMID: 33387241 DOI: 10.1007/s10803-020-04824-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2020] [Indexed: 12/28/2022]
Abstract
Measurement-based care (MBC), an evidence-based approach that has demonstrated efficacy for improving treatment outcomes, has yet to be investigated in clients with Autism Spectrum Disorder. The current paper investigates the use of MBC in autistic (n = 20) and non-autistic (n = 20) clients matched on age, sex, and presenting problem. Results of change score analysis indicated that utilizing routine symptom monitoring can enhance treatment evaluation. Autistic clients participated in significantly more sessions, made significantly less progress, and were less compliant with MBC than non-autistic clients. Though hierarchical linear modeling demonstrated no significant differences in treatment slope, results indicated moderate effect size. These results inform the use of MBC in community clinics, highlighting policy implications and need for targeted measurement.
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Affiliation(s)
- Tyler C McFayden
- Department of Psychology, Virginia Tech, 460 Turner Street NW, Suite 207, Blacksburg, VA, 24060, USA.
| | - Alyssa J Gatto
- Department of Psychology, Virginia Tech, 460 Turner Street NW, Suite 207, Blacksburg, VA, 24060, USA
| | - Angela V Dahiya
- Department of Psychology, Virginia Tech, 460 Turner Street NW, Suite 207, Blacksburg, VA, 24060, USA
| | - Ligia Antezana
- Department of Psychology, Virginia Tech, 460 Turner Street NW, Suite 207, Blacksburg, VA, 24060, USA
| | - Yasuo Miyazaki
- Department of Education Research and Evaluation, Virginia Tech, Blacksburg, VA, USA
| | - Lee D Cooper
- Department of Psychology, Virginia Tech, 460 Turner Street NW, Suite 207, Blacksburg, VA, 24060, USA
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30
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Goodman AC, Ouellette RR, D'Agostino EM, Hansen E, Lee T, Frazier SL. Promoting healthy trajectories for urban middle school youth through county-funded, parks-based after-school programming. J Community Psychol 2021; 49:2795-2817. [PMID: 33914915 DOI: 10.1002/jcop.22587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 04/04/2021] [Accepted: 04/05/2021] [Indexed: 06/12/2023]
Abstract
Ongoing pressure for public schools to prioritize academics has increased attention on after-school settings as a critical space for social-emotional learning (SEL). After-school programs are uniquely positioned to build protective and promotive factors that contribute to positive future orientation, especially within communities where systemic inequities create barriers to high school graduation, higher education, employment, and earnings. This study examines Fit2Lead Youth Enrichment and Sports (YES), a county-funded, parks-based after-school collaboration for middle schoolers that merges mental health and recreation to promote healthy trajectories. Eight Miami neighborhood parks were selected based on county data indicating high rates of violence. An open trial design (N = 9 parks, 198 youth; ages 9-15; 40.5% female; 66.5% Black/African American, 24.9% Hispanic/Latinx, and 76.3% low-income) tested hypotheses that participation for adolescents exposed to community violence would disrupt a commonly reported decline in self-regulation and self-efficacy, and mitigate risk for anxiety and depression. Youth completed questionnaires at the beginning and end of one school year. Paired t-tests revealed no changes from pre to post, and no differences by baseline levels of youth and parent mental health. Findings highlight the promise of prevention programs to disrupt downward trajectories for youth during the risky time of early adolescence.
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Affiliation(s)
- Allison C Goodman
- Department of Psychology, Florida International University, Miami, Florida, USA
| | - Rachel R Ouellette
- Department of Psychology, Florida International University, Miami, Florida, USA
| | - Emily M D'Agostino
- Department of Family Medicine and Community Health, and Department of Population Health Science, Duke University, Durham, North Carolina, USA
- Miami-Dade County Department of Parks, Recreation and Open Spaces, Miami, Florida, USA
| | - Eric Hansen
- Miami-Dade County Department of Parks, Recreation and Open Spaces, Miami, Florida, USA
| | - Theodore Lee
- Department of Psychology, Florida International University, Miami, Florida, USA
| | - Stacy L Frazier
- Department of Psychology, Florida International University, Miami, Florida, USA
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31
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Mactavish A, Mastronardi C, Menna R, Babb KA, Battaglia M, Amstadter AB, Rappaport LM. Children's Mental Health in Southwestern Ontario during Summer 2020 of the COVID-19 Pandemic. J Can Acad Child Adolesc Psychiatry 2021; 30:177-190. [PMID: 34381510 DOI: 10.31234/osf.io/5cwb4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 04/12/2021] [Indexed: 05/23/2023]
Abstract
OBJECTIVE COVID-19 presents an unprecedented global crisis. Research is critically needed to identify the impact of the pandemic on children's mental health including psychosocial factors that predict resilience, recovery, and persistent distress. The present study collected data in June-July 2020 to describe children's mental health during the initial phase of the pandemic, including the magnitude and nature of psychiatric and psychological distress in children, and to evaluate social support as a putative psychosocial moderator of children's increased distress. METHOD Children and parents from 190 families of children aged 8 to 13 from the Windsor-Essex region of Southwestern Ontario reported (i) retrospectively on children's well-being (e.g., worry, happiness) immediately prior to the pandemic and (ii) on children's current well-being; irritability; social support; and anxiety, depressive, and posttraumatic stress symptoms at the baseline assessment of an ongoing longitudinal study of the COVID-19 pandemic. RESULTS Children and parents reported worsened well-being and psychological distress during the pandemic compared to retrospective report of pre-pandemic well-being. Child-perceived social support from family and friends was associated with lower symptom severity and attenuated increase in psychological distress. CONCLUSIONS Study findings suggest possible broad psychological impacts of the COVID-19 pandemic and are consistent with prior research that indicates a protective role of social support to mitigate the negative psychological impact of the pandemic. These findings may inform clinical assessments and highlight the need for public resources to safeguard children's mental health.
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Affiliation(s)
| | | | - Rosanne Menna
- Department of Psychology, University of Windsor, Windsor, Ontario
| | - Kimberley A Babb
- Department of Psychology, University of Windsor, Windsor, Ontario
| | - Marco Battaglia
- Department of Psychiatry, University of Toronto, Toronto, Ontario; Division of Child and Youth, Centre for Addiction and Mental Health, Toronto, Ontario
| | - Ananda B Amstadter
- Virginia Institute for Psychiatric and Behavioral Genetics, Departments of Psychiatry and Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA, USA
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Bashford-Largo J, Aloi J, Zhang R, Bajaj S, Carollo E, Elowsky J, Schwartz A, Dobbertin M, Blair RJR, Blair KS. Reduced neural differentiation of rewards and punishment during passive avoidance learning in adolescents with generalized anxiety disorder. Depress Anxiety 2021; 38:794-803. [PMID: 33739566 PMCID: PMC8328882 DOI: 10.1002/da.23150] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 01/21/2021] [Accepted: 03/02/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND It has been proposed that individuals with generalized anxiety disorder (GAD) show dysfunctional computations related to approach-avoidance decision-making. However, few studies have examined the neural basis of this impairment, particularly in adolescents with GAD. The goal of the current study was to address this gap in the literature. METHOD The study involved 51 adolescents with GAD and 51 typically developing (TD) comparison individuals matched on age (16.10 and 15.75 respective means), gender (30 F/21 M and 24 F/27 M), and IQ (103.20 and 103.18 respective means). Participants underwent functional magnetic resonance imaging during a passive avoidance task. RESULTS We found a significant Group-by-Reinforcement interaction within reward-related brain regions including the caudate, putamen, mid cingulate/paracentral lobule, and superior and middle frontal gyrus. TD adolescents showed a greater differential response to reward versus punishment feedback within these regions relative to adolescents with GAD. In particular, this reflected reduced responses to rewards in the adolescents with GAD. There were no group differences in neural responses when making approach/avoidance responses. CONCLUSION The results of this study suggest reduced differential responsiveness to reinforcement as a component of the pathophysiology seen in adolescents with GAD. This dysfunction likely underpins decision-making impairments that may exacerbate the participants' worry.
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Affiliation(s)
- Johannah Bashford-Largo
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska, USA
| | - Joseph Aloi
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska, USA,Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Ru Zhang
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska, USA
| | - Sahil Bajaj
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska, USA
| | - Erin Carollo
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska, USA
| | - Jaimie Elowsky
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska, USA
| | - Amanda Schwartz
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska, USA
| | - Matthew Dobbertin
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska, USA
| | - R. James R. Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska, USA
| | - Karina S. Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska, USA
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33
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Bilgin A, Wolke D, Baumann N, Trower H, Brylka A, Räikkönen K, Heinonen K, Kajantie E, Schnitzlein D, Lemola S. Changes in emotional problems, hyperactivity and conduct problems in moderate to late preterm children and adolescents born between 1958 and 2002 in the United Kingdom. JCPP Adv 2021; 1:e12018. [PMID: 37431476 PMCID: PMC10242980 DOI: 10.1111/jcv2.12018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 04/09/2021] [Indexed: 11/30/2022] Open
Abstract
Background Preterm birth is a risk factor for the development of emotional and behavioural problems in childhood and adolescence. Given the substantial improvements in neonatal care across decades, it has been expected that the difference in emotional problems, hyperactivity, and conduct problems between moderate to late preterm (MLPT) and full term (FT) children and adolescents have declined in recent years. Methods Data from four UK population-based studies were used: The National Child Development Study (NCDS; 1958), the British Cohort Study (BCS70; 1970), the Avon Longitudinal Study of Parents and Children (ALSPAC, 1991-1992) and the Millennium Cohort Study (MCS; 2000-2002). Emotional problems, hyperactivity and conduct problems were assessed with mother-reports in early childhood (5-7 years), late childhood (10-11 years) and adolescence (14-16 years). Furthermore, emotional problems were self-reported in adolescence in BCS70, ALSPAC and MCS. Results In the most recent cohort, the MLPT group had higher mother-reported emotional problems than those born FT in late childhood and adolescence, whereas there were no differences in self-reported emotional problems in adolescence. Regarding mother-reported hyperactivity symptoms, the MLPT group had higher scores than the FT group in the two most recent cohorts in late childhood and in the most recent cohort in adolescence. Regarding mother-reported conduct problems, MLPT children had significantly higher scores than the FT children in the oldest and in the most recent cohort in late childhood. On the other hand, in adolescence, MLPT children had significantly lower scores in conduct problems in comparison to FT children in the cohort born in 1991-1992. Conclusions Mother-reported emotional problems and hyperactivity symptoms of those born MLPT have increased from the birth years 1958 to 2000-2002 during late childhood and adolescence, whereas self-reported emotional problems were similar in MLPT and FT groups during adolescence from 1970 to 2000-2002. Findings are less consistent regarding conduct problems. The current findings highlight the importance of raising the awareness of teachers about the association between MLPT birth and behavioural and emotional problems in late childhood and adolescence to prevent the long-term negative outcomes associated with the sequalae of MLPT birth.
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Affiliation(s)
- Ayten Bilgin
- School of PsychologyUniversity of KentCanterburyUK
- Department of PsychologyUniversity of WarwickCoventryUK
| | - Dieter Wolke
- Department of PsychologyUniversity of WarwickCoventryUK
- Division of Mental Health and WellbeingWarwick Medical SchoolUniversity of WarwickCoventryUK
| | | | - Hayley Trower
- Department of PsychologyUniversity of WarwickCoventryUK
| | | | - Katri Räikkönen
- Department of Psychology & LogopedicsUniversity of HelsinkiHelsinkiFinland
| | - Kati Heinonen
- Department of Psychology & LogopedicsUniversity of HelsinkiHelsinkiFinland
- Psychology/ Welfare SciencesFaculty of Social SciencesTampere UniversityFinland
| | - Eero Kajantie
- National Institute for Health and WelfareHelsinkiFinland
- Medical Research Center OuluPEDEGO Research UnitOulu University Hospital and University of OuluOuluFinland
- Pediatric Research CenterChildren’s HospitalUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
- Department of Clinical and Molecular MedicineNorwegian University of Science and TechnologyTrondheimNorway
| | - Daniel Schnitzlein
- Institute of Labour EconomicsLeibniz University of HannoverHannoverGermany
- DIW BerlinBerlinGermany
- IZA BonnBonnGermany
| | - Sakari Lemola
- Department of PsychologyUniversity of WarwickCoventryUK
- Department of PsychologyUniversity of BielefeldBielefeldGermany
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Peterson BS, West AE, Weisz JR, Mack WJ, Kipke MD, Findling RL, Mittman BS, Bansal R, Piantadosi S, Takata G, Koebnick C, Ashen C, Snowdy C, Poulsen M, Arora BK, Allem CM, Perez M, Marcy SN, Hudson BO, Chan SH, Weersing R. A Sequential Multiple Assignment Randomized Trial (SMART) study of medication and CBT sequencing in the treatment of pediatric anxiety disorders. BMC Psychiatry 2021; 21:323. [PMID: 34193105 PMCID: PMC8243307 DOI: 10.1186/s12888-021-03314-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 06/04/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Treatment of a child who has an anxiety disorder usually begins with the question of which treatment to start first, medication or psychotherapy. Both have strong empirical support, but few studies have compared their effectiveness head-to-head, and none has investigated what to do if the treatment tried first isn't working well-whether to optimize the treatment already begun or to add the other treatment. METHODS This is a single-blind Sequential Multiple Assignment Randomized Trial (SMART) of 24 weeks duration with two levels of randomization, one in each of two 12-week stages. In Stage 1, children will be randomized to fluoxetine or Coping Cat Cognitive Behavioral Therapy (CBT). In Stage 2, remitters will continue maintenance-level therapy with the single-modality treatment received in Stage 1. Non-remitters during the first 12 weeks of treatment will be randomized to either [1] optimization of their Stage 1 treatment, or [2] optimization of Stage 1 treatment and addition of the other intervention. After the 24-week trial, we will follow participants during open, naturalistic treatment to assess the durability of study treatment effects. Patients, 8-17 years of age who are diagnosed with an anxiety disorder, will be recruited and treated within 9 large clinical sites throughout greater Los Angeles. They will be predominantly underserved, ethnic minorities. The primary outcome measure will be the self-report score on the 41-item youth SCARED (Screen for Child Anxiety Related Disorders). An intent-to-treat analysis will compare youth randomized to fluoxetine first versus those randomized to CBT first ("Main Effect 1"). Then, among Stage 1 non-remitters, we will compare non-remitters randomized to optimization of their Stage 1 monotherapy versus non-remitters randomized to combination treatment ("Main Effect 2"). The interaction of these main effects will assess whether one of the 4 treatment sequences (CBT➔CBT; CBT➔med; med➔med; med➔CBT) in non-remitters is significantly better or worse than predicted from main effects alone. DISCUSSION Findings from this SMART study will identify treatment sequences that optimize outcomes in ethnically diverse pediatric patients from underserved low- and middle-income households who have anxiety disorders. TRIAL REGISTRATION This protocol, version 1.0, was registered in ClinicalTrials.gov on February 17, 2021 with Identifier: NCT04760275 .
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Affiliation(s)
- Bradley S. Peterson
- grid.239546.f0000 0001 2153 6013Children’s Hospital Los Angeles, Los Angeles, CA USA ,grid.42505.360000 0001 2156 6853Department of Psychiatry, Keck School of Medicine at The University of Southern California, Los Angeles, USA
| | - Amy E. West
- grid.239546.f0000 0001 2153 6013Children’s Hospital Los Angeles, Los Angeles, CA USA ,grid.42505.360000 0001 2156 6853Department of Pediatrics, Keck School of Medicine at the University of Southern California, Los Angeles, USA
| | - John R. Weisz
- grid.38142.3c000000041936754XDepartment of Psychology, Harvard University, Cambridge, USA
| | - Wendy J. Mack
- grid.42505.360000 0001 2156 6853Department of Preventive Medicine, Keck School of Medicine at The University of Southern California, Los Angeles, USA
| | - Michele D. Kipke
- grid.239546.f0000 0001 2153 6013Children’s Hospital Los Angeles, Los Angeles, CA USA ,grid.42505.360000 0001 2156 6853Department of Pediatrics, Keck School of Medicine at the University of Southern California, Los Angeles, USA ,grid.42505.360000 0001 2156 6853Department of Preventive Medicine, Keck School of Medicine at The University of Southern California, Los Angeles, USA
| | - Robert L. Findling
- grid.224260.00000 0004 0458 8737Virginia Commonwealth University, Richmond, USA
| | - Brian S. Mittman
- grid.414895.50000 0004 0445 1191Department of Research & Evaluation, Kaiser Permanente, Los Angeles, USA
| | - Ravi Bansal
- grid.239546.f0000 0001 2153 6013Children’s Hospital Los Angeles, Los Angeles, CA USA ,grid.42505.360000 0001 2156 6853Department of Pediatrics, Keck School of Medicine at the University of Southern California, Los Angeles, USA
| | - Steven Piantadosi
- grid.38142.3c000000041936754XBrigham And Women’s Hospital, Harvard Medical School, Boston, USA
| | - Glenn Takata
- grid.239546.f0000 0001 2153 6013Children’s Hospital Los Angeles, Los Angeles, CA USA ,grid.42505.360000 0001 2156 6853Department of Pediatrics, Keck School of Medicine at the University of Southern California, Los Angeles, USA
| | - Corinna Koebnick
- grid.414895.50000 0004 0445 1191Department of Research & Evaluation, Kaiser Permanente, Los Angeles, USA
| | - Ceth Ashen
- Children’s Bureau of Southern California, Los Angeles, USA
| | - Christopher Snowdy
- grid.42505.360000 0001 2156 6853Department of Psychiatry, Keck School of Medicine at The University of Southern California, Los Angeles, USA
| | - Marie Poulsen
- grid.239546.f0000 0001 2153 6013Children’s Hospital Los Angeles, Los Angeles, CA USA ,grid.42505.360000 0001 2156 6853Department of Pediatrics, Keck School of Medicine at the University of Southern California, Los Angeles, USA
| | - Bhavana Kumar Arora
- grid.239546.f0000 0001 2153 6013Children’s Hospital Los Angeles, Los Angeles, CA USA ,grid.42505.360000 0001 2156 6853Department of Pediatrics, Keck School of Medicine at the University of Southern California, Los Angeles, USA
| | - Courtney M. Allem
- grid.239546.f0000 0001 2153 6013Children’s Hospital Los Angeles, Los Angeles, CA USA
| | - Marisa Perez
- Hathaway-Sycamores Child and Family Services, Altadena, USA
| | - Stephanie N. Marcy
- grid.239546.f0000 0001 2153 6013Children’s Hospital Los Angeles, Los Angeles, CA USA ,grid.42505.360000 0001 2156 6853Department of Pediatrics, Keck School of Medicine at the University of Southern California, Los Angeles, USA
| | - Bradley O. Hudson
- grid.239546.f0000 0001 2153 6013Children’s Hospital Los Angeles, Los Angeles, CA USA ,grid.42505.360000 0001 2156 6853Department of Pediatrics, Keck School of Medicine at the University of Southern California, Los Angeles, USA
| | | | - Robin Weersing
- grid.263081.e0000 0001 0790 1491SDSU-UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University, San Diego, USA
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35
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Neumer SP, Patras J, Holen S, Lisøy C, Askeland AL, Haug IM, Jeneson A, Wentzel-Larsen T, Adolfsen F, Rasmussen LMP, Ingul JM, Ytreland K, Bania EV, Sund AM, Martinsen K. Study protocol of a factorial trial ECHO: optimizing a group-based school intervention for children with emotional problems. BMC Psychol 2021; 9:97. [PMID: 34154666 PMCID: PMC8215478 DOI: 10.1186/s40359-021-00581-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 05/04/2021] [Indexed: 12/19/2022] Open
Abstract
Background Youth mental health problems are a major public health concern. Anxiety and depression are among the most common psychological difficulties. The aim of this study is to evaluate an optimized version of a promising indicated group intervention for emotional problems. The program (EMOTION Coping Kids Managing Anxiety and Depression) targets school children 8–12 years with anxious and depressive symptoms and examines three factors. Factor 1 compares the standard EMOTION intervention delivered in 16 group-based sessions (Group), versus a partially-digital EMOTION intervention (DIGGI) delivered as eight group sessions and eight digital sessions. Both versions use virtual reality technology (VR) to improve behavioral experiments. Factor 2 compares parent participation in a 5-session parent group (high involvement) versus sharing information with parents via a brochure (low involvement). Factor 3 compares the use of a measurement and feedback system (MFS) designed to help group leaders tailor the intervention using feedback from children with no MFS. Methods Using a cluster-randomized factorial design, 40 schools across Norway will be randomized to eight different experimental conditions based on three, two-level factors. To assess internalizing symptoms in children, children and their parents will be given self-report questionnaires pre-, post-, and one year after intervention. Parents also report on demographics, user satisfaction, personal symptoms and perception of family related factors. Teachers report on child symptoms and school functioning. Group leaders and the head of the municipal services report on implementation issues. The primary outcomes are changes in depressive and anxious symptoms. Some secondary outcomes are changes in self-esteem, quality of life, and user satisfaction. Questions regarding the consequences of the COVID-19 pandemic are included. Treatment fidelity is based on checklists from group leaders, and on user data from the participating children. Discussion This study is a collaboration between three regional centers for child and adolescent mental health in Norway. It will provide knowledge about: (1) the effect of school-based preventive interventions on anxiety and depression in children; (2) the effect of feedback informed health systems, (3) the effect and cost of digital health interventions for children, and (4) the effect of parental involvement. Supplementary Information The online version contains supplementary material available at 10.1186/s40359-021-00581-y.
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Affiliation(s)
- Simon-Peter Neumer
- The Center for Child and Adolescent Mental Health - Eastern and Southern Norway, Postboks 4623, 0405, Nydalen, Oslo, Norway. .,The Regional Centre for Child and Youth Mental Health and Child Welfare - Northern Norway, RKBU Nord UiT Norges Arktiske Universitet, 9037, Tromsø, Norway.
| | - Joshua Patras
- The Regional Centre for Child and Youth Mental Health and Child Welfare - Northern Norway, RKBU Nord UiT Norges Arktiske Universitet, 9037, Tromsø, Norway
| | - Solveig Holen
- The Center for Child and Adolescent Mental Health - Eastern and Southern Norway, Postboks 4623, 0405, Nydalen, Oslo, Norway
| | - Carina Lisøy
- The Center for Child and Adolescent Mental Health - Eastern and Southern Norway, Postboks 4623, 0405, Nydalen, Oslo, Norway
| | - Anne Liv Askeland
- The Center for Child and Adolescent Mental Health - Eastern and Southern Norway, Postboks 4623, 0405, Nydalen, Oslo, Norway
| | - Ida Mari Haug
- The Regional Centre for Child and Youth Mental Health and Child Welfare - Northern Norway, RKBU Nord UiT Norges Arktiske Universitet, 9037, Tromsø, Norway
| | - Annette Jeneson
- The Center for Child and Adolescent Mental Health - Eastern and Southern Norway, Postboks 4623, 0405, Nydalen, Oslo, Norway
| | - Tore Wentzel-Larsen
- The Center for Child and Adolescent Mental Health - Eastern and Southern Norway, Postboks 4623, 0405, Nydalen, Oslo, Norway.,Norwegian Centre for Violence and Traumatic Stress Studies, 0484, Oslo, Norway
| | - Frode Adolfsen
- The Regional Centre for Child and Youth Mental Health and Child Welfare - Northern Norway, RKBU Nord UiT Norges Arktiske Universitet, 9037, Tromsø, Norway
| | - Lene-Mari Potulski Rasmussen
- The Regional Centre for Child and Youth Mental Health and Child Welfare - Northern Norway, RKBU Nord UiT Norges Arktiske Universitet, 9037, Tromsø, Norway
| | - Jo Magne Ingul
- The Regional Centre for Child and Youth Mental Health and Child Welfare - Central Norway, MTFS, Pb 8905, 7491, Trondheim, Norway
| | - Kristin Ytreland
- The Regional Centre for Child and Youth Mental Health and Child Welfare - Central Norway, MTFS, Pb 8905, 7491, Trondheim, Norway
| | - Elisabeth Valmyr Bania
- The Regional Centre for Child and Youth Mental Health and Child Welfare - Central Norway, MTFS, Pb 8905, 7491, Trondheim, Norway
| | - Anne Mari Sund
- The Regional Centre for Child and Youth Mental Health and Child Welfare - Central Norway, MTFS, Pb 8905, 7491, Trondheim, Norway.,St.Olavs Hospital, Trondheim University Hospital, Prinsesse Kristinas gate 3, 7030, Trondheim, Norway
| | - Kristin Martinsen
- The Center for Child and Adolescent Mental Health - Eastern and Southern Norway, Postboks 4623, 0405, Nydalen, Oslo, Norway.,Department of Psychology, University of Oslo, Forskningsveien 3A, 0373, Oslo, Norway
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Kim H, Kim K, Kim JW. The Reliability and Validity of the Korean Version of the Mood and Feelings Questionnaire for Depression in Youth: A Cross-Cultural Perspective. Child Psychiatry Hum Dev 2021; 52:399-408. [PMID: 32671498 DOI: 10.1007/s10578-020-01026-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
We aimed to assess cross-cultural differences in depressive symptoms and the validity of the Korean version of the Mood and Feelings Questionnaire (MFQ). Four hundred and sixty-four children and adolescents (aged 7-19, 278 girls) with any psychiatric diagnosis, 290 of whom had major depressive disorder, were included. The levels of depressive symptoms in children and adolescents were evaluated by children/adolescents and their parents. We conducted Pearson's r and Cronbach's α, confirmative factor analysis and item response theory tests. The Korean version of the MFQ demonstrated excellent criterion validity and discriminant validity. There were no cultural differences in the clinical manifestations of depression in youth from Western countries and Korea. Korean youths with depression were more likely to complain of cognitive and emotional symptoms than somatic symptoms. The Korean version of the MFQ demonstrated promising psychometric properties in a clinical sample of children and adolescents.
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Affiliation(s)
- Haebin Kim
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Psychiatry, Kyung Hee University Hospital, Seoul, Republic of Korea
| | - Kyoungmin Kim
- Department of Psychiatry, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Jae-Won Kim
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea. .,Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea. .,Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
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Mundy LK, Canterford L, Moreno-Betancur M, Hoq M, Sawyer SM, Allen NB, Patton GC. Social networking and symptoms of depression and anxiety in early adolescence. Depress Anxiety 2021; 38:563-570. [PMID: 33225486 DOI: 10.1002/da.23117] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 10/04/2020] [Accepted: 11/05/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Use of social networking in later childhood and adolescence has risen quickly. The consequences of these changes for mental health are debated but require further empirical evaluation. METHODS Using data from the Childhood to Adolescence Transition Study (n = 1,156), duration of social networking use was measured annually at four time points from 11.9 to 14.8 years of age (≥1 h/day indicating high use). Cross-sectional and prospective relationships between social networking use and depressive and anxiety symptoms were examined. RESULTS In adjusted (age, socioeconomic status, prior mental health history) cross-sectional analyses, females with high social networking use had greater odds of depressive (odds ratio [OR]: 2.15; 95% confidence interval [CI]: 1.58-2.91) and anxiety symptoms (OR: 1.99; 95% CI: 1.32-3.00) than those that used a few minutes at most, while males with high social networking use had 1.60 greater odds of reporting depressive symptoms (95% CI: 1.09-2.35). For females, an increased odds of depressive symptoms at age 14.8 was observed for high social networking use at one previous wave and at two or three previous waves, even after adjustment (OR: 1.76; 95% CI: 1.11-2.78; OR: 2.06, 95% CI: 1.27-3.37, respectively) compared to no wave of high use. CONCLUSIONS Our results suggest weak to moderate increased odds of depression and anxiety in girls and boys with high social networking use versus low/normal use. These findings indicate that prevention programs for early mental health problems might benefit from targeting social networking use in early adolescence.
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Affiliation(s)
- Lisa K Mundy
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Louise Canterford
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Margarita Moreno-Betancur
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia.,Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Monsurul Hoq
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Susan M Sawyer
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Nicholas B Allen
- Department of Psychology, University of Oregon, Eugene, Oregon, USA
| | - George C Patton
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
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Juul EML, Hjemdal O, Aune T. Prevalence of depressive symptoms among older children and young adolescents: a longitudinal population-based study. Scand J Child Adolesc Psychiatr Psychol 2021; 9:64-72. [PMID: 33928055 PMCID: PMC8077432 DOI: 10.21307/sjcapp-2021-008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Introduction This paper investigates levels of depressive symptoms among older children and young adolescents, 11-14 years of age. The population-based sample was assessed twice during a 12-month period. Point-prevalence, 12-month prevalence, and 12-month incidence were measured by a validated self-reported scale (SFMQ) and are presented in this paper. Methods A total of 2148 pupils were invited to participate in this study, and 1748 pupils and at least one parent/guardian provided informed consent. The population was assessed twice within one 12-month period resulting in 1439 participants at both data collection points. Depressive symptoms were measured by a validated self-reported scale, The Short Mood and Feelings Questionnaire (SMFQ). Results The results indicate that the point-prevalence was just under 10% in 6th to 10th grade with a 12-month prevalence at almost 3%. The results also indicate an incidence rate of 4.5% over 12-months. This study confirms that girls report a higher range of point prevalence, 12- month-prevalence, and 12-month incidence compared to boys. Conclusions The results indicate that depressive symptoms among children and young adolescents is a serious health challenge. The results demonstrate substantial gender differences even at an early age (11-14 years), where girls report significantly higher point prevalence, 12-month-prevalence, and 12-month incidence compared to boys. Results from this study suggest that depressive symptoms are an important problem that young adolescents face, and the study underlines the need for more intervention tailored to gender at the middle-school level, especially with respect to those children and adolescents who experience persistent depressive symptoms.
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Affiliation(s)
| | - Odin Hjemdal
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Tore Aune
- Faculty of Nursing and Health Sciences, Nord University, Levanger.,Norwegian Directorate for Children, Youth and Family Affairs, Oslo, Norway
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Prins SJ, Kajeepeta S, Pearce R, Beardslee J, Pardini D, Cerdá M. Identifying sensitive periods when changes in parenting and peer factors are associated with changes in adolescent alcohol and marijuana use. Soc Psychiatry Psychiatr Epidemiol 2021; 56:605-617. [PMID: 32915245 PMCID: PMC8715643 DOI: 10.1007/s00127-020-01955-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 09/01/2020] [Indexed: 01/05/2023]
Abstract
PURPOSE There are well-established associations between parental/peer relationships and adolescent substance use, but few longitudinal studies have examined whether adolescents change their substance use in response to changes in their parents' behavior or peer networks. We employ a within-person change approach to address two key questions: Are changes in parenting and peer factors associated with changes in adolescent marijuana and alcohol use? Are there sensitive periods when changes in parenting and peer factors are more strongly associated with changes in adolescent marijuana and alcohol use? METHODS We analyzed longitudinal data collected annually on 503 boys, ages 13-19, recruited from Pittsburgh public schools. Questionnaires regarding parental supervision, negative parenting practices, parental stress, physical punishment, peer delinquency, and peer drug use were administered to adolescents and their caretakers. Alcohol and marijuana use were assessed by a substance use scale adapted from the National Youth Survey. RESULTS Reductions in parental supervision and increases in peer drug use and peer delinquency were associated with increases in marijuana frequency, alcohol frequency, and alcohol quantity. Increases in parental stress were associated with increases in marijuana and alcohol frequency. The magnitudes of these relationships were strongest at ages 14-15 and systematically decreased across adolescence. These associations were not due to unmeasured stable confounders or measured time-varying confounders. CONCLUSIONS Reducing or mitigating changes in parenting and peer risk factors in early adolescence may be particularly important for preventing substance use problems as adolescents transition into young adulthood.
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Affiliation(s)
| | | | | | - Jordan Beardslee
- University of California, Irvine, Department of Psychological Science
| | - Dustin Pardini
- School of Criminology & Criminal Justice, Arizona State University
| | - Magdalena Cerdá
- Department of Population Health, NYU School of Medicine, New York, NY
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Witt K, Milner A, Evans-Whipp T, Toumbourou JW, Patton G, LaMontagne AD. Educational and Employment Outcomes among Young Australians with a History of Depressive Symptoms: A Prospective Cohort Study. Int J Environ Res Public Health 2021; 18:ijerph18073376. [PMID: 33805164 PMCID: PMC8036767 DOI: 10.3390/ijerph18073376] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/08/2021] [Accepted: 03/19/2021] [Indexed: 12/18/2022]
Abstract
The aim of this study was to investigate whether depressive symptoms reported during adolescence are associated with subsequent educational and employment outcomes, including whether experiences of depressive symptoms in adolescence are associated with higher exposures to adverse psychosocial job stressors among those who were employed in emerging adulthood. We used data from the Victorian arm of the International Youth Development Study (IYDS). Multiple logistic regression analyses were used to model the association of depressive symptoms reported in 2002 (wave one) and/or 2003 (wave two) and self-reported completion of compulsory secondary schooling, employment status, and exposure to a number of psychosocial job stressors roughly a decade later (i.e., at wave three in 2014). In fully adjusted models, reporting high depressive symptoms at waves one or two (odds ratio (OR) 0.71, 95% confidence interval (CI) 0.55 to 0.92), as well as at both waves (OR 0.55, 95% CI 0.41 to 0.75) were associated with a reduced likelihood of completing secondary schooling by wave three. High depressive symptoms reported at multiple waves were also associated with a reduced likelihood of employment (OR 0.49, 95% CI 0.36 to 0.66). Amongst those employed at wave three (n = 2091; 72.5%), adolescent depressive symptoms were associated only with workplace incivility. Psychosocial job stressor exposures should be considered in the design and selection of jobs for young workers with a history of depressive symptoms in order to increase employment participation and sustainability for young people experiencing symptoms of depression.
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Affiliation(s)
- Katrina Witt
- Turning Point, Eastern Health Clinical School, Monash University, Richmond 3121, Australia;
| | - Allison Milner
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Parkville 3052, Australia;
| | - Tracy Evans-Whipp
- Centre for Adolescent Health, Murdoch Children’s Research Institute, Parkville 3052, Australia; (T.E.-W.); (G.P.)
- Department of Paediatrics, Royal Children’s Hospital and The University of Melbourne, Parkville 3052, Australia
| | | | - George Patton
- Centre for Adolescent Health, Murdoch Children’s Research Institute, Parkville 3052, Australia; (T.E.-W.); (G.P.)
- Department of Paediatrics, Royal Children’s Hospital and The University of Melbourne, Parkville 3052, Australia
| | - Anthony D. LaMontagne
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Parkville 3052, Australia;
- Institute for Health Transformation and School of Health and Social Development, Deakin University, Geelong 3220, Australia
- Correspondence:
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Bendiksen B, Heir T, Minteh F, Ziyada MM, Kuye RA, Lien IL. The association between physical complications following female genital cutting and the mental health of 12-year-old Gambian girls: A community-based cross-sectional study. PLoS One 2021; 16:e0245723. [PMID: 33481926 PMCID: PMC7822282 DOI: 10.1371/journal.pone.0245723] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 01/05/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Female genital cutting (FGC) involve an acute physical trauma that hold a potential risk for immediate and long-term complications and mental health problems. The aim of this study was to examine the prediction of depressive symptoms and psychological distress by the immediate and current physical complications following FGC. Further, to examine whether the age at which 12-year-old Gambian girls had undergone the procedure affected mental health outcomes. METHOD This cross-sectional study recruited 134 12-year-old girls from 23 public primary schools in The Gambia. We used a structured clinical interview to assess mental health and life satisfaction, including the Short Mood and Feeling Questionnaire (SMFQ), the Symptom check list (SCL-5) and Cantril's Ladder of Life Satisfaction. Each interview included questions about the cutting procedure, immediate- and current physical complications and the kind of help and care girls received following FGC. RESULTS Depressive symptoms were associated with immediate physical health complications in a multivariate regression model [RR = 1.08 (1.03, 1.12), p = .001], and with present urogenital problems [RR = 1.19 (1.09, 1.31), p < .001]. The girls that received medical help following immediate complications had a lower risk for depressive symptoms [RR = .73 (.55, .98), p = .04]. Psychological distress was only associated with immediate complications [RR = 1.04 (1.01, 1.07), p = .004]. No significant differences in mental health outcomes were found between girls who underwent FGC before the age of four in comparison to girls who underwent FGC after the age of four. CONCLUSION Our findings indicate that the immediate and long-term complications following FGC have implications for psychological health. Only a minimal number of girls received medical care when needed, and the dissemination of health education seems crucial in order to prevent adverse long-term physical and psychological health consequences.
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Affiliation(s)
- Bothild Bendiksen
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
- * E-mail:
| | - Trond Heir
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
- The University of Oslo, Institute of Clinical Medicine, Oslo, Norway
| | - Fabakary Minteh
- Department of Public & Environmental Health, School of Medicine & Allied Health Sciences, University of The Gambia, Brikama Campus, The Gambia
| | - Mai Mahgoub Ziyada
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
- The University of Oslo, Institute of Clinical Medicine, Oslo, Norway
| | - Rex A. Kuye
- Department of Public & Environmental Health, School of Medicine & Allied Health Sciences, University of The Gambia, Brikama Campus, The Gambia
| | - Inger-Lise Lien
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
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Morales-Muñoz I, Broome MR, Marwaha S. Association of Parent-Reported Sleep Problems in Early Childhood With Psychotic and Borderline Personality Disorder Symptoms in Adolescence. JAMA Psychiatry 2020; 77:1256-1265. [PMID: 32609357 PMCID: PMC7330826 DOI: 10.1001/jamapsychiatry.2020.1875] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
IMPORTANCE Persistent nightmares in childhood have been prospectively associated with psychosis and borderline personality disorder (BPD) in adolescence. However, the extent to which this association is also true for behavioral sleep problems is still unknown, and the potential mechanisms are unexplored. OBJECTIVE To examine the prospective associations between several parent-reported sleep problems in early childhood and psychotic and BPD symptoms at 11 to 13 years of age and the potential mediation of the associations by depression at 10 years of age. DESIGN, SETTING, AND PARTICIPANTS This cohort study assessed 13 488 participants in the Avon Longitudinal Study of Parents and Children birth cohort who were followed up for more than 13 years. Pregnant women from Avon, United Kingdom, with expected dates of delivery from April 1, 1991, to December 31, 1992, were invited to take part in the study. Data analysis was conducted from May 1 to December 31, 2019. MAIN OUTCOMES AND MEASURES Psychotic experiences at 12 to 13 years of age were assessed using the Psychosis-Like Symptom Interview, and BPD symptoms at 11 to 12 years of age were tested using the UK Childhood Interview for DSM-IV Borderline Personality Disorder. Parent-reported nighttime sleep duration, night awakening frequency, bedtime, and regularity of sleep routines were assessed when the child was 6, 18, and 30 months and 3.5, 4.8, and 5.8 years of age. RESULTS Data were available on 7155 participants (3718 girls [52%]) who reported on BPD symptoms and 6333 (3280 boys [52%]) who reported on BPD symptoms. Higher night awakening frequency at 18 months of age (odds ratio [OR], 1.13; 95% CI, 1.01-1.26) and less regular sleep routines at 6 months (OR, 0.68; 95% CI, 0.50-0.93), 30 months (OR, 0.64; 95% CI, 0.44-0.95), and 5.8 years (OR, 0.32; 95% CI, 0.19-0.53) of age were significantly associated with psychotic experiences in adolescence, whereas shorter nighttime sleep duration (OR, 0.78; 95% CI, 0.66-0.92) and later bedtime at 3.5 years of age (OR, 1.32; 95% CI, 1.09-1.60) were significantly associated with BPD symptoms. Results of mediation analysis were consistent with all these associations, except for later bedtime at 3.5 years and BPD in adolescence, which had no association. Depression at 10 years of age mediated the associations between frequent night awakenings at 18 months of age (bias-corrected estimate, -0.005; 95% CI, -0.008 to -0.002; P = .002) and irregular sleep routines at 5.8 years of age (bias-corrected estimate, -0.006; 95% CI, -0.010 to -0.003; P = .003) with psychosis. CONCLUSIONS AND RELEVANCE The findings suggest that some behavioral sleep problems in childhood are distinctively associated with the onset of psychosis and BPD in adolescence, following different pathways. Furthermore, depression at 10 years of age may mediate only the association with psychosis. These findings contribute to the design of more personalized interventions in psychosis and BPD.
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Affiliation(s)
- Isabel Morales-Muñoz
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland,Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Matthew R. Broome
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Steven Marwaha
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, United Kingdom,The Barberry National Centre for Mental Health, Birmingham, United Kingdom
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Lloyd B, Macdonald JA, Youssef GJ, Knight T, Letcher P, Sanson A, Olsson CA. Negative reactivity and parental warmth in early adolescence and depressive symptoms in emerging adulthood. Australian Journal of Psychology 2020. [DOI: 10.1111/ajpy.12129] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Brendan Lloyd
- School of Psychology and Centre for Social and Early Emotional Development, Deakin University, Geelong, Victoria, Australia,
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria, Australia,
| | - Jacqui A. Macdonald
- School of Psychology and Centre for Social and Early Emotional Development, Deakin University, Geelong, Victoria, Australia,
- Murdoch Childrens Research Institute, Centre for Adolescent Health, The Royal Children's Hospital, Parkville, Victoria, Australia,
- The University of Melbourne, The Royal Children's Hospital, Parkville, Victoria, Australia,
| | - George J. Youssef
- School of Psychology and Centre for Social and Early Emotional Development, Deakin University, Geelong, Victoria, Australia,
- Murdoch Childrens Research Institute, Centre for Adolescent Health, The Royal Children's Hospital, Parkville, Victoria, Australia,
| | - Tess Knight
- School of Psychology and Centre for Social and Early Emotional Development, Deakin University, Geelong, Victoria, Australia,
| | - Primrose Letcher
- The University of Melbourne, The Royal Children's Hospital, Parkville, Victoria, Australia,
| | - Ann Sanson
- The University of Melbourne, The Royal Children's Hospital, Parkville, Victoria, Australia,
| | - Craig A. Olsson
- School of Psychology and Centre for Social and Early Emotional Development, Deakin University, Geelong, Victoria, Australia,
- Murdoch Childrens Research Institute, Centre for Adolescent Health, The Royal Children's Hospital, Parkville, Victoria, Australia,
- The University of Melbourne, The Royal Children's Hospital, Parkville, Victoria, Australia,
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Fernández-Martínez I, Morales A, Méndez FX, Espada JP, Orgilés M. Spanish Adaptation and Psychometric Properties of the Parent Version of the Short Mood and Feelings Questionnaire (SMFQ-P) in a Non-Clinical Sample of Young School-Aged Children. Span J Psychol 2020; 23:e45. [PMID: 33148355 DOI: 10.1017/sjp.2020.47] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The parent version of the Short Mood and Feelings Questionnaire (SMFQ-P) is a brief 13-item tool for the screening of depression in children from the age of 6 years. Despite the wide use of the SMFQ-P, its psychometric properties and factor structure remain understudied, with few data available for young school-aged children. The objective of this study was to examine for the first time the factorial structure and psychometric properties of the SMFQ-P in a non-clinical sample of Spanish-speaking children aged 6-8 years. Participants were 181 children whose parents completed the Spanish-adapted version of the SMFQ-P along with the parent version of other measures of anxiety and general difficulties and positive attributes. The SMFQ-P demonstrated adequate internal consistency (α = .83) and test-retest reliability over an eight-week period (ICC = .80), and good convergent and divergent validity. Factor analysis confirmed the original 13-item model, thus supporting the unidimensionality of the measure in the Spanish sample. Overall, this study provides initial empirical evidence for the utility of the SMFQ-P with Spanish-speaking children from early school ages, and extends the international support of the measure.
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Jeffrey J, Klomhaus A, Enenbach M, Lester P, Krishna R. Self-Report Rating Scales to Guide Measurement-Based Care in Child and Adolescent Psychiatry. Child Adolesc Psychiatr Clin N Am 2020; 29:601-629. [PMID: 32891365 DOI: 10.1016/j.chc.2020.06.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Measurement-based care involves the practice of systematically administrating rating scales to patients in order to use the collected information to enhance clinical evaluation, monitor treatment progress, and directly inform decisions relating to each patient's treatment. Rating scales must be psychometrically validated and efficiently administered within the practice setting. Brief rating scales that are available within the public domain may help to optimize workflows and prevent response fatigue. Clinicians should also have a sufficient understanding of the underlying psychometric properties of rating scales to accurately interpret changes in scores over time and use these results to appropriately direct care.
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Affiliation(s)
- Jessica Jeffrey
- Department of Psychiatry and Biobehavioral Sciences, Division of Population Behavioral Health, Nathanson Family Resilience Center, Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, 760 Westwood Plaza, A8-153, Los Angeles, CA 90095, USA.
| | - Alexandra Klomhaus
- Department of Psychiatry and Biobehavioral Sciences, Division of Population Behavioral Health, Nathanson Family Resilience Center, Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, 760 Westwood Plaza, A8-153, Los Angeles, CA 90095, USA; Department of Biostatistics, UCLA Fielding School of Public Health, 650 Charles E. Young Dr. South, Los Angeles, CA 90095, USA
| | - Michael Enenbach
- Department of Psychiatry and Biobehavioral Sciences, Division of Population Behavioral Health, Nathanson Family Resilience Center, Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, 760 Westwood Plaza, A8-153, Los Angeles, CA 90095, USA; Department of Psychiatry & Biobehavioral Sciences, Division of Child and Adolescent Psychiatry, Jane and Terry Semel Institute of Neuroscience and Human Behavior at UCLA, 760 Westwood Plaza, 48-270, Los Angeles, CA 90095, USA
| | - Patricia Lester
- Department of Psychiatry and Biobehavioral Sciences, Division of Population Behavioral Health, Nathanson Family Resilience Center, Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, 760 Westwood Plaza, A8-153, Los Angeles, CA 90095, USA
| | - Rajeev Krishna
- Psychiatry and Behavioral Health, Nationwide Children's Hospital, Psychiatry T5, 700 Children's Drive, Columbus, OH 43205, USA
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Abstract
Systematic mental health screening is a recommended but controversial process in the pediatricians' behavioral health tool kit. Although the American Academy of Pediatrics and other organizations promote routine behavioral health screening, implementing an effective and sustainable screening program can be challenging. We discuss the rationale for and barriers to screening in pediatric settings, identify accessible validated tools that can be easily incorporated into practice, and suggest a practical strategy for implementing a more accurate screening system for common mental health concerns in pediatric primary care. [Pediatr Ann. 2020;49(10):e421-e425.].
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Brikell I, Larsson H, Lu Y, Pettersson E, Chen Q, Kuja-Halkola R, Karlsson R, Lahey BB, Lichtenstein P, Martin J. The contribution of common genetic risk variants for ADHD to a general factor of childhood psychopathology. Mol Psychiatry 2020; 25:1809-1821. [PMID: 29934545 PMCID: PMC6169728 DOI: 10.1038/s41380-018-0109-2] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 04/01/2018] [Accepted: 05/14/2018] [Indexed: 01/20/2023]
Abstract
Common genetic risk variants have been implicated in the etiology of clinical attention-deficit/hyperactivity disorder (ADHD) diagnoses and symptoms in the general population. However, given the extensive comorbidity across ADHD and other psychiatric conditions, the extent to which genetic variants associated with ADHD also influence broader psychopathology dimensions remains unclear. The aim of this study was to evaluate the associations between ADHD polygenic risk scores (PRS) and a broad range of childhood psychiatric symptoms, and to quantify the extent to which such associations can be attributed to a general factor of childhood psychopathology. We derived ADHD PRS for 13,457 children aged 9 or 12 from the Child and Adolescent Twin Study in Sweden, using results from an independent meta-analysis of genome-wide association studies of ADHD diagnosis and symptoms. We estimated associations between ADHD PRS, a general psychopathology factor, and several dimensions of neurodevelopmental, externalizing, and internalizing symptoms, using structural equation modeling. Higher ADHD PRS were statistically significantly associated with elevated neurodevelopmental, externalizing, and depressive symptoms (R2 = 0.26-1.69%), but not with anxiety. After accounting for a general psychopathology factor, on which all symptoms loaded positively (mean loading = 0.50, range = 0.09-0.91), an association with specific hyperactivity/impulsivity remained significant. ADHD PRS explained ~ 1% (p value < 0.0001) of the variance in the general psychopathology factor and ~ 0.50% (p value < 0.0001) in specific hyperactivity/impulsivity. Our results suggest that common genetic risk variants associated with ADHD, and captured by PRS, also influence a general genetic liability towards broad childhood psychopathology in the general population, in addition to a specific association with hyperactivity/impulsivity symptoms.
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Affiliation(s)
- Isabell Brikell
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Yi Lu
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Statistical Genetics, Genetics and Computational Biology Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Erik Pettersson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Qi Chen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Ralf Kuja-Halkola
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Robert Karlsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Benjamin B Lahey
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Joanna Martin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
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Jarbin H, Ivarsson T, Andersson M, Bergman H, Skarphedinsson G. Screening efficiency of the Mood and Feelings Questionnaire (MFQ) and Short Mood and Feelings Questionnaire (SMFQ) in Swedish help seeking outpatients. PLoS One 2020; 15:e0230623. [PMID: 32210463 PMCID: PMC7094832 DOI: 10.1371/journal.pone.0230623] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 03/04/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND To evaluate screening efficiency and suggest cut-offs for parent and child Mood and Feelings Questionnaire (MFQ) and the short version (SMFQ) in unselected help seeking child- and adolescent psychiatric outpatients for subgroups of 6-12 versus 13-17 year olds and boys versus girls. METHOD Eligible for inclusion were newly admitted outpatients age 6-17 years (n = 5908) in four Swedish child- and adolescent psychiatry clinics. They were prompted consecutively and n = 307 accepted a specific day for assessment until time slots randomly were filled. We prospectively validated the MFQ (33 items) and SMFQ (13 items) in patients (n = 186) using receiver operating characteristics against a reference test of Longitudinal Expert All Data DSM-IV depression based on a Kiddie-Schedule for Affective Disorders and Schizophrenia and 1.2 (sd .6) years of follow-up. RESULTS A depressive disorder was confirmed in 59 (31.7%) patients ranging from 14.0% for girls 6-12 years to 53.3% for girls 13-17 years. SMFQ performed roughly equivalent to MFQ. Adolescent score on SMFQ discriminated fairly for boys with Area Under Curve .77 (95% confidence interval .59-.81) and good (.82, .69-.91) for girls and parent ratings for adolescent girls (.85, .73-.93), but not for boys. Depression in children below age 13 could not be discriminated by MFQ or SMFQ whether filled in by child and mostly also when filled in by parent. Favouring maximum kappa value, the optimal cut-off was for MFQ self-report girls ≥32 versus boys ≥11 and for SMFQ self-report girls ≥17 versus boys ≥ 6. Suggested clinical SMFQ cut-offs for girls were ≥12 and for boys ≥ 6. CONCLUSIONS MFQ and SMFQ can, with gender-based cut-offs, be used for screening in clinical populations of adolescents but not in children. Parent MFQ and SMFQ can be used for adolescent girls but not boys. SMFQ is sufficient for screening.
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Affiliation(s)
- Håkan Jarbin
- Faculty of Medicine, Department of Clinical Sciences Lund, Lund University, Child and Adolescent Psychiatry, University of Lund, Lund, Sweden
| | - Tord Ivarsson
- Department of Mental Health, Regional Centre for Child and Youth Mental Health and Child Welfare, Faculty of Medicine and Health Science, RKBU Midt-Norge, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Markus Andersson
- Faculty of Medicine, Department of Clinical Sciences Lund, Lund University, Child and Adolescent Psychiatry, University of Lund, Lund, Sweden
| | - Hanna Bergman
- Child and adolescent psychiatry, Region Halland, Varberg, Sweden
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Hamer M, Patalay P, Bell S, Batty GD. Change in device-measured physical activity assessed in childhood and adolescence in relation to depressive symptoms: a general population-based cohort study. J Epidemiol Community Health 2020; 74:330-335. [PMID: 31974294 DOI: 10.1136/jech-2019-213399] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 12/06/2019] [Accepted: 12/10/2019] [Indexed: 11/04/2022]
Abstract
AIM Evidence for a link between physical activity and mental health in young people is hampered by methodological shortcomings. Using repeat assessments of device-measured physical activity, we examined the association of within-individual variation in free-living activity over 7 years with depressive symptoms. METHODS This was a prospective cohort study of a nationally representative sample of children born in the UK (n=4898). Physical activity was quantified using accelerometry at ages 7 and 14. The main outcome was depressive symptoms, based on the Short Mood and Feelings Questionnaire, assessed at age 14. RESULTS After adjustment for socioeconomic status, body mass index and psychological problems at baseline, a higher level of light-intensity activity at age 7 in girls was associated with a lower likelihood of having depressive symptoms at follow-up (OR, 0.79; 95% CI 0.61 to 1.00), although no associations were observed for moderate to vigorous activity or sedentary behaviour. Girls who transitioned from low baseline activity to higher levels at follow-up experienced a lower risk of depressive symptoms (OR, 0.60; 95% CI 0.39 to 0.92) compared with the inactive reference category. Null associations were observed in boys. Participants who consistently met the current recommendation of 60 min/day of moderate to vigorous activity both at 7 and 14 years of age experienced the lowest risk of depressive symptoms (OR, 0.55; 95% CI 0.34 to 0.88). CONCLUSION To prevent depressive symptoms in adolescence, policies to increase physical activity from mid-childhood may have utility.
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Affiliation(s)
- Mark Hamer
- Institute Sport Exercise Health, Division Surgery Interventional Science, University College London, London, UK
| | - Praveetha Patalay
- Centre Longitudinal Studies, Institute Education, University College London, London, UK
| | - Steven Bell
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - G David Batty
- Department Epidemiology Public Health, University College London, London, UK.,School of Biological & Population Health Sciences, Oregon State University, Corvallis, Oregon, USA
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Sevilla-Cermeño L, Rautio D, Andrén P, Hillborg M, Silverberg-Morse M, Lahera G, Mataix-Cols D, Fernández de la Cruz L. Prevalence and impact of insomnia in children and adolescents with body dysmorphic disorder undergoing multimodal specialist treatment. Eur Child Adolesc Psychiatry 2020; 29:1289-1299. [PMID: 31760510 PMCID: PMC7497371 DOI: 10.1007/s00787-019-01442-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 11/12/2019] [Indexed: 11/25/2022]
Abstract
Pediatric body dysmorphic disorder (BDD) is challenging to treat. This study aimed to establish the prevalence of insomnia in youth with BDD and explore its impact on clinical outcomes. Sixty-six children and adolescents with BDD consecutively referred to a specialist clinic completed a range of clinical measures, including the Yale-Brown Obsessive-Compulsive Scale Modified for BDD-Adolescent Version (BDD-YBOCS-A), and the Insomnia Severity Index (ISI). Patients with clinical insomnia (ISI score ≥ 9) were compared to the rest of the sample on socio-demographic and clinical features. Fifty-six patients who received multimodal treatment were re-assessed post-treatment. A mixed-model ANOVA was performed to compare treatment outcomes between the insomnia vs. no insomnia groups, and Chi-squared tests were used to compare response and remission rates. According to the ISI, 48% of the sample qualified as having insomnia at baseline. These participants showed significantly higher self-reported BDD symptom severity, more depressive symptoms, and more functional impairment in daily activities. Patients with insomnia improved less on the BDD-YBOCS-A than those without insomnia, although the difference did not reach statistical significance. The rates of responders and remitters were lower in the insomnia group, compared to the non-insomnia group. Insomnia is prevalent in pediatric BDD, and is associated with more severe psychopathology and worse functioning in daily activities. Furthermore, youth experiencing BDD and insomnia may benefit from multimodal treatment to a lesser extent than those without insomnia. If these results are replicated in larger samples, treatment refinements for pediatric BDD could include specific modules to directly target insomnia.
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Affiliation(s)
- Laura Sevilla-Cermeño
- Karolinska Institutet, Department of Clinical Neuroscience, Child and Adolescent Psychiatry Research Center, Gävlegatan 22 (Entré B), Floor 8, 113 30, Stockholm, Sweden.
- Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden.
- Departamento de Medicina y Especialidades Médicas, Universidad de Alcalá, Madrid, Spain.
| | - Daniel Rautio
- Karolinska Institutet, Department of Clinical Neuroscience, Child and Adolescent Psychiatry Research Center, Gävlegatan 22 (Entré B), Floor 8, 113 30, Stockholm, Sweden
- Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Per Andrén
- Karolinska Institutet, Department of Clinical Neuroscience, Child and Adolescent Psychiatry Research Center, Gävlegatan 22 (Entré B), Floor 8, 113 30, Stockholm, Sweden
- Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Maria Hillborg
- Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | | | - Guillermo Lahera
- Departamento de Medicina y Especialidades Médicas, Universidad de Alcalá, Madrid, Spain
| | - David Mataix-Cols
- Karolinska Institutet, Department of Clinical Neuroscience, Child and Adolescent Psychiatry Research Center, Gävlegatan 22 (Entré B), Floor 8, 113 30, Stockholm, Sweden
- Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Lorena Fernández de la Cruz
- Karolinska Institutet, Department of Clinical Neuroscience, Child and Adolescent Psychiatry Research Center, Gävlegatan 22 (Entré B), Floor 8, 113 30, Stockholm, Sweden
- Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
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