Prospective Longitudinal Associations Between Persistent Sleep Problems in Childhood and Anxiety and Depression Disorders in Adulthood

The objective of this study was to examine the associations between persistent childhood sleep problems and adulthood anxiety and depression. Parents of 943 children (52% male) participating in the Dunedin Multidisciplinary Health and Development Study provided information on their childrens sleep and internalizing problems at ages 5, 7, and 9 years. When the participants were 21 and 26 years, adult anxiety and depression were diagnosed using a standardized diagnostic interview. After controlling for childhood internalizing problems, sex, and socioeconomic status, persistent sleep problems in childhood predicted adulthood anxiety disorders (OR (95% CI) = 1.60 (1.05–2.45), p = .030) but not depressive disorders (OR (95% CI) = .99 (.63–1.56), p = .959). Persistent sleep problems in childhood may be an early risk indicator of anxiety in adulthood.     

Health-related Internet habits and health anxiety in university students

Health-related Internet use has grown rapidly, yet little research has considered how health anxious individuals use the Internet for this purpose. Our aim was to examine the relationships between health anxiety and the extent of, reasons for, and consequences of health-related Internet usage in university students (n = 255). Responses on a purpose-made Internet use questionnaire were correlated with health anxiety scores; multiple regression analyses controlling for depression and anxiety were also conducted. Health anxiety positively correlated with (all ps < .01): frequency of health-related searching (r_s = .163), proportion of health-related information sought (r_s = .200), time spent online for health purposes (r_s = .166), and number of searches for both illness (r_s = .453) and wellness (r_s = .208) information. Health anxiety further positively correlated with advantages perceived in health-related Internet use (r_s = .183), heightened tension (r_s = .364) and relief (r_s = .174) post-search, and perceived doctor disadvantages (r_s = .306), yet a greater likelihood to visit a doctor post-search (r_s = .217). Health anxiety also correlated with six measures of possible addiction to using the Internet for health purposes (r_s range = .171 to .366, all ps < .01). Some (including several potentially dysfunctional) aspects of health-related Internet use correlate with health anxiety. Research evaluating the possible role of Internet use in the development and maintenance of health anxiety is warranted.     

Childhood Trauma Predicts Positive Expressive Suppression During Social Affiliation in Adults With Anxiety and/or Depression: Implications for Social Functioning

Experiencing childhood trauma (CT) can create barriers for developing relationships and is a risk factor for anxiety and depression. Expressive suppression (ES; i.e., reducing expression associated with experiencing emotions) might explain the link between CT and relationship formation difficulties. We examined the association between (1) CT and ES during a dyadic paradigm intended to facilitate connectedness between unacquainted partners and (2) ES and desire for future interaction (DFI). Individuals with an anxiety or depressive disorder diagnosis (N = 77) interacted with a trained confederate; partners answered a series of increasingly intimate questions about themselves. Participant ES for positive and negative emotions, and participant and confederate DFI were collected during the task. Participants completed global anxiety, depression, and CT measures. CT correlated with positive (r = .35, p = .002), but not negative, ES (r = .13, p = .273). In a multiple linear regression model, CT predicted positive ES beyond symptom variables and gender, β = .318, t = 2.59, p = .012. Positive ES correlated with participant (r = ?.38, p = .001) and confederate DFI (r = ?.40, p<.01); and predicted participant DFI beyond symptom variables and ethnicity, β = ?.358, t = ?3.18, p = .002, and confederate DFI, β = ?.390, t = ?3.51, p = .001, beyond symptom variables. Mediation analyses suggested positive ES accounted for the relationship between greater CT severity and less desire for future interaction from participants, 95%CI [?0.26, ?0.02], and confederates, [?0.38, ?0.01]. Positive ES may be an important factor in the reduced capacity to form new social relationships for individuals with a history of CT, anxiety, and depression.     

Hearing Impairment, Coping Strategies, and Anxiety Sensitivity

The aim was to study coping strategies among hearing-impaired individuals by using a validated coping instrument—The Ways of Coping Questionnaire (WOCQ; S. Folkman & R. Lazarus, 1988)—and to relate the use of coping with anxiety sensitivity and experience of hearing impairment. A questionnaire booklet was sent out to the members of the local branch of the Swedish Hard of Hearing Association. Ninety-four members responded to the questionnaire, yielding a 53% response rate. Primary outcome measures were the WOCQ, the Anxiety Sensitivity Index, and visual analogue scale rating of discomfort from hearing impairment. Repeated measures analysis of WOCQ subscales showed that the participants used planful problem solving and self-controlling coping strategies whereas escape/avoidance responses were less frequently used than the other coping strategies. Anxiety sensitivity was associated with escape/avoidance coping (r = .63, p < .0001). In conclusion, hearing-impaired individuals do not use escape/avoidance coping more than other coping strategies. However, escape/avoidance coping is associated with anxiety sensitivity, suggesting that sensitivity to anxiety sensations is an important associated factor. Coping strategies were not associated with discomfort from hearing impairment in any meaningful way.     

The dermatology life quality index (DLQI) and the hospital anxiety and depression (HADS) in Chinese rosacea patients

The study aims to investigate the quality of life (QOL) and the psychological situation in Chinese patients with rosacea. A total of 196 healthy controls and 201 rosacea patients were involved in the final analysis. The general information, the Dermatology Life Quality Index (DLQI) and the Hospital Anxiety and Depression Scale (HADS) were collected. Significantly higher DLQI, anxiety and depression score were observed in the rosacea group compared to the control group (p < .01). Total DLQI score of patients was positively related with anxiety (r = .526, p < .001) and depression scores (r = .399, p < .001) in HADS. Rosacea had significant psychological impact on Chinese patients and had substantial influence on their QOL. Physicians should address the psychosocial needs of rosacea patients as much as its physical symptoms.     

Family influences on the association between sleep problems and anxiety in a large sample of pre-school aged twins

Research suggests that environmental influences are important on the association between sleep problems and anxiety in children. This study examines family influences on the association between sleep problems and anxiety in 6000+ twin pairs. Parents provided information on their twins’ anxiety and sleep problems at ages 3 and 4 years. The family influences maternal depression, life events, socio-economic status, family illness, and family disorganization, were examined using parent-report. Family disorganization and maternal depression showed the strongest correlations with sleep problems (r = .20, .21, respectively) and with anxiety (r = .24, .28). Subsequent analyses indicated that family disorganization and maternal depression (examined individually) each accounted for approximately 30% of the association between sleep problems and anxiety (r = .18). The remaining association was mainly explained by environmental factors making children in the same family alike and genetic influences. This study specifies family influences that may be important in the association between sleep problems and anxiety and highlights areas of research that may be worth pursuing in order to further understand the childhood association between sleep problems and anxiety.     

The psychometric properties of the Greek version of the State-Trait Anxiety Inventory in cancer patients receiving palliative care

Objectives: To validate the Greek version of the State-Trait Anxiety Inventory (STAI) in a sample of cancer patients. Design: The scale was administered twice, with a 3-day interval, to 99 eligible patients with cancer. Together with the Greek version of STAI scale, the patients also completed the anxiety subscale from the Hospital Anxiety and Depression scale (HAD). Observations: Factor analysis yielded a three-factor solution, explaining 47.143% of the variance. Cronbach α for three scales was between 0.729 and 0.852. Inter-scale correlations were moderate-to-high and ranged from 0.282 to 0.563 (p < 0.0005, p < 0.005). The assessment of the relationships among the Greek STAI scales and HAD-Anxiety showed statistically significant correlations between them (r ranged between 0.428 and 0.596, p < 0.0005). The test/retest reliability of scale (Pearson's ‘r’), showed that the coefficient agreement ranged between 0.85 and 0.90 (p < 0.0005). Univariate analysis revealed significant correlations between female gender, metastasis, performance status, chemotherapy, mild opioids and low education level with increased anxiety. Conclusions: These results support that the Greek version of STAI is an instrument with satisfactory psychometric properties, and is a valid research tool for Greek cancer patients.     

Differentiation of self and trait anxiety: A cross‐cultural perspective

Cultural differences are likely to affect the ability to deal with anxiety. We investigated this issue among four cultural groups—Germans and Italians (Europeans living in South Tyrol, Italy), Jews and Arabs (Israelis)—in terms of their levels of differentiation of self, trait anxiety and somatic symptoms. We also examined the relationship of differentiation of self to trait anxiety and somatic symptoms. The sample consisted of 824 students: 387 Israelis (mean age 23.6) and 437 Europeans (mean age 22.3). Israeli participants reported lower levels of trait anxiety than European students. Jewish students reported lower trait anxiety than Arab students (mean difference = ?.14, p < .009), while there was no difference between German and Italian students (mean difference = .03, p > .99). Jews reported a significantly lower level of emotional cutoff than Arabs (mean difference = ?.45, p < .001), and Germans reported a significantly lower level of emotional reactivity than Italians (mean difference = .29, p < .001). Emotional reactivity and I‐position predicted all participants' trait anxiety. On the whole, results point to the importance of examining differentiation of self when trying to reduce trait anxiety, as well as some important cultural differences.     

The relationship between child-report, parent self-report, and partner report of perceived parental rearing behaviors and anxiety in children and parents

This study investigated the relationship between child anxiety, parental anxiety, and perceived current parental rearing practices, using a multiple informants approach, that is, by aggregating the perception of the child, parent and partner on parental rearing behaviors. Unselected children aged 9–12 (n=75) and both their biological parents filled in the SCARED-C to measure child anxiety, and parents completed the SCARED-A to measure parental anxiety. In addition, child report, parental self-report, and partner report of the rearing dimensions “autonomy-encouragement versus overprotection”, “acceptance versus rejection”, and “psychological control” of both parents was assessed. Results showed that the homogeneity of some rearing dimensions using a single informant was insufficient, but sufficient when using multiple informants. Inter-informant agreement was low (M=0.29). Three-informants' aggregates yielded good generalizability (M=0.54), and the generalizability of six-informants' aggregates (combining both parents) was impressive (M=0.76). Using multiple informants, parental autonomy granting versus overprotection was substantially related to child anxiety (r=−0.41, p<0.001), as well as to parental anxiety (r=−0.45, p<0.001). More precisely, paternal autonomy–overprotection was predominantly related to child anxiety, whereas maternal autonomy–overprotection was predominantly related to maternal anxiety. Acceptance versus rejection and psychological control were only modestly related to child and parental anxiety.     

Maternal and paternal parenting styles associated with relational aggression in children and adolescents: A conceptual analysis and meta-analytic review

How does parenting affect relational aggression in children? The goal of the present series of meta-analyses based on 48 studies (28,097 children) was to analyze and integrate the findings on the associations between various types of parenting behaviors and relational aggression, and to identify potential substantive and methodological factors that may moderate these associations. To distinguish between different parenting strategies, experts sorted the parenting measures used in the studies into 10 groups. Results of a multiple correspondence analysis revealed four separate clusters: Positive parenting, psychologically controlling parenting, negative/harsh parenting, and uninvolved parenting. The meta-analyses demonstrated that more positive parenting was associated with less relational aggression (combined effect sizes r = −.06, p < .05, for mothers, r = −.08, p < .01, for fathers). More harsh parenting (combined effect sizes r = .11, p < .01, for mothers, r = .12, p < .01, for fathers) and more uninvolved parenting (combined effect sizes r = .07, p < .01, for mothers, absent for fathers) were associated with increased relational aggression. Paternal psychologically controlling parenting was positively related to relational aggression (r = .05, p < .01), whereas maternal psychologically controlling parenting was not (combined effect sizes r = .04, p = .09). The effect of several moderators is discussed. The findings of this study suggest that dimensions of positive and negative parenting behaviors of mothers and fathers are associated with children’s relational aggression and that these associations are – in case of fathers – contingent upon a number of sampling and procedural characteristics.     

Anxiety sensitivity as a specific and unique marker of anxious symptoms in youth psychiatric inpatients

We addressed several questions regarding the relation of anxiety sensitivity to anxious symptoms among 47 youth psychiatric inpatients (18 boys, 29 girls), ages 9–17 (M = 14.23, SD = 1.89). Participants completed measures of anxiety sensitivity, anxious and depressive symptoms, trait anxiety, and positive and negative affect; chart diagnoses were available. Consistent with hypotheses, we found that (a) anxiety sensitivity was associated with anxious symptoms, even controlling for trait anxiety and depressive symptoms; and (b) anxiety sensitivity displayed symptom specificity to anxious versus depressive symptoms (i.e., was associated with anxiety controlling for depression but not with depression controlling for anxiety). Furthermore, regarding factors of anxiety sensitivity, we obtained mixed support for our prediction that phrenophobia would be associated with both depression and anxiety, whereas fear of physical arousal would be associated with anxiety but not depression. Implications for the construct validity of anxiety sensitivity were discussed.     

Motivation for physical activity in young adults with physical disabilities during a rehabilitation stay: a longitudinal test of self‐determination theory

We tested a self‐determination theory (SDT) process model during a 3 week physical activity rehabilitation stay among young adults with a physical disability (N = 44, M_age = 24.7, SD = 5.1). As hypothesized, perceived autonomy support positively predicted needs satisfaction at the end of the stay (r = .38, p < .01). Further, needs satisfaction was positively linked to changes in autonomous motivation for physical activity (r = .47, p < .01). Both changes in autonomous motivation and self‐efficacy were associated with physical activity increases over the stay (r = .57, p < .01 and r = .47, p < .01, respectively). Bootstrapping results supported the SDT process model, indicating a support for a development toward more self‐determined motivation in rehabilitation.     

Does a self management intervention lower distress in woman diagnosed with breast cancer?1

Psychological distress is particularly common with any cancer diagnosis. This paper examined the psychological distress in a cohort of women newly diagnosed with breast cancer and postulates on the underlying theory. A longitudinal study of a cohort of women (n = 147) diagnosed with breast cancer (within the past 1 year), was conducted at University Malaya Medical Centre, Kuala Lumpur. Data were collected at baseline and at post 4‐week intervention. Analysis of variance was conducted to examine for any significant differences in the change‐scores between the experimental group (n = 69) and the control group (n = 78). Using the change scores, analyses of variance showed significant differences between groups for stress, F(1, 140) = 13.68, p < .0001, anxiety F(1, 140) = 8.44, p < .004, and depression, F(1, 140) = 11.57, p < .0001. Levels of stress, anxiety and depression generally decreased significantly in the experimental groups, p < .05, but either maintained or increased in the control group. This study indicates that the level of psychological distress of women with breast cancer can be ameliorated with a 4‐week self‐management intervention. Lower stress levels were also found in women who reported engagement in higher physical activity than women with low physical activity.     

Temperamental Vulnerability and Suicide Risk After Attempted Suicide

The aim was to extend recent findings of suggested temperamental features in attempted suicide and to explore possible domains of vulnerability to suicide risk after attempted suicide. Fifty-four psychiatric inpatients hospitalized after a suicide attempt underwent lumbar puncture for analysis of CSF 5-HIAA concentration and also completed the Karolinska Scales of Personality (KSP) before discharge from the hospital. Suicide attempters scored high on Somatic Anxiety, Psychic Anxiety, and Muscular Tension, and low on Socialization, findings that support recent findings in suicide attempters followed up after an emergency room visit. Five patients committed early suicide, i.e., within 3 years, and the overall long-term suicide mortality after attempted suicide was 13%. There were significant correlations between survival time among early suicides and CSF 5-HIAA (r = .87;p = .054), and the following KSP scale t scores: Somatic Anxiety (r = ?.96;p < .05), Impulsivity (r = ?.88; p < .05), and Socialization (r = .90; p < .05). KSP Socialization showed correlations with CSF 5-HIAA (r = .89; p = .046) among the early suicides. Features of temperamental vulnerability to suicide risk after attempted suicide might involve anxiety proneness, impulsivity, low socialization, and low CSF 5-HIAA.     

Institutional care and iron deficiency increase ADHD symptomology and lower IQ 2.5–5 years post‐adoption

Increased ADHD symptomology and lower IQ have been reported in internationally adopted (IA) children compared to non‐adopted peers (Hostinar, Stellern, Schaefer, Carlson & Gunnar, 2012; Kreppner, O'Connor & Rutter, 2001). However, it is unclear whether these outcomes are due to institutional deprivation specifically or to co‐occurring micronutrient deficiencies that disrupt brain development (Fuglestad, Rao & Georgieff, 2008b). In this study, IA children were compared to children raised in their biological families to examine differences in ADHD symptomology and IQ 2.5–5 years post‐adoption and to assess the contributions of iron deficiency (ID) and duration of deprivation to these cognitive outcomes. ADHD symptoms (parent‐ and experimenter‐reported) and IQ were evaluated in 88 IA (M = 62.1 months, SD = 2.4) and 35 non‐adopted children (M = 61.4 months, SD = 1.6). IA children were assessed 29–64 months post‐adoption (M = 41.9 months, SD = 10.2). ID was assessed during the initial post‐adoption medical visit in 69 children, and children were classified into four groups by iron status, ranging from normal to ID anemia (most severe). IA children had greater ADHD symptomology, p < .01, and lower IQ, p = .001, than non‐adopted children. Within the IA group, children with more severe ID at adoption had greater ADHD symptomology, r(69) = 0.40, p = .001, and lower IQ, r(68) = −0.28, p < .05. Duration of institutional care was positively correlated with ADHD symptoms, r(86) = .28, p < .01, but not IQ, r(85) = −.08, p = .52. Longitudinal results indicate improvement in IQ from 12 months post‐adoption to age 5 for children with greater ID severity at adoption and longer duration of institutional care but no improvement in ADHD symptoms. These results signify continuing effects of early deprivation and ID on ADHD symptoms and IQ years after adoption. A video abstract of this article can be viewed at http://www.youtube.com/watch?v=vUFDAS3DD1c     

The Relationship Between Parent and Child Dysfunctional Beliefs About Sleep and Child Sleep

Cognitive theories emphasise the role of dysfunctional beliefs about sleep in the development and maintenance of sleep-related problems (SRPs). The present research examines how parents’ dysfunctional beliefs about children’s sleep and child dysfunctional beliefs about sleep are related to each other and to children’s subjective and objective sleep. Participants were 45 children aged 11–12 years and their parents. Self-report measures of dysfunctional beliefs about sleep and child sleep were completed by children, mothers and fathers. Objective measures of child sleep were taken using actigraphy. The results showed that child dysfunctional beliefs about sleep were correlated with father (r = 0.43, p < 0.05) and mother (r = 0.43, p < 0.05) reported child SRPs, and with Sleep Onset Latency (r = 0.34, p < 0.05). Maternal dysfunctional beliefs about child sleep were related to child SRPs as reported by mothers (r = 0.44, p < 0.05), and to child dysfunctional beliefs about sleep (r = 0.37, p < 0.05). Some initial evidence was found for a mediation pathway in which child dyfunctional beliefs mediate the relationship between parent dysfunctional beliefs and child sleep. The results support the cognitive model of SRPs and contribute to the literature by providing the first evidence of familial aggregation of dysfunctional beliefs about sleep.     

Internet-delivered cognitive behavior therapy for anxiety and insomnia in a higher education context

Background and Objectives: Anxiety and insomnia can be treated with internet-delivered Cognitive Behavioral Therapy (iCBT). iCBT may be well-suited to students who are known to be poor help-seekers and suffer these symptoms. iCBT can offer easy access to treatment and increase service availability. The aim of this study was to evaluate the efficacy of anxiety and insomnia iCBT programs in students. Design: A randomized, controlled study. Methods: Students were randomly allocated to intervention (“Anxiety Relief”: n?=?43; “Insomnia Relief”: n?=?48; control: n?=?47). Interventions lasted six weeks. Outcome measures were the State-Trait Anxiety Inventory and the Pittsburgh Sleep Quality Index. Results: Significant within-group reductions in anxiety (t(31)?=?2.00, p?=?.03) with moderate between-groups (compared to control) effect size (d?=?.64) and increases in sleep quality (t(31)?=?3.46, p?=?.002) with a moderate between-groups effect size (d?=?.55) were found for completers of the anxiety program from pre- to post-intervention. Significant within-group increases in sleep quality were found for completers of the insomnia program from pre- to post-intervention (t(35)?=?4.28, p?>?.001) with a moderate between-groups effect size (d?=?.51). Conclusions: Findings support the use of iCBT for anxiety and insomnia in students, and indicate that further research is needed.     

Effects of emotion regulation strategies on anxiety during job interviews in Chinese college students

Background and objectives: Few studies related to the impact of different emotion regulation strategies on anxiety have used externally and ecologically valid emotion-eliciting stimuli or Eastern populations. The present study compares the effects of reappraisal, suppression, and acceptance on anxiety induced by a simulated job interview in a Chinese sample. Methods: Eighty-two subjects were randomly assigned to one of four instructions: reappraisal, suppression, acceptance, or no-regulation strategies during a simulated job interview. Anxiety was assessed with an observer-based behavior rating scale during the interview and the State Anxiety Inventory before, during, and after the interview. Results: A repeated-measures MANOVA indicated a significantly greater reduction in anxiety in the reappraisal and acceptance groups compared to the control group during the interview (reappraisal: d = 1.42; acceptance: d = 1.30; each p < .001), but not during the recovery stage. The suppression and control group did not differ in any stage. Suppression led to a higher (p_max < .04) anxiety than reappraisal/acceptance in the anticipation (d = 0.65/0.68), interview (d = 0.87/0.79), and recovery stages (d = 0.94/1.03). No significant differences were found between reappraisal and acceptance. Conclusions: In Chinese students reappraisal and acceptance seem to be more effective anxiety regulation strategies than suppression.     

Habit as both a direct cause of intention to use a condom and as a moderator of the attitude-intention and subjective norm-intention relations

Abstract

Undergraduates at an American university were asked questions about their attitudes, subjective norms, habits, and intentions towards using a condom during sexual intercourse. Consistent with previous research (Chan and Fishbein, 1993; Trafimow, 1994), intentions were well predicted by attitudes and subjective norms (r = 0.88 and r = 0.73, p < 0.01 in both cases). Intentions were also well predicted by habits (r = 0.77, p < 0.01). More interestingly, however, for participants who were in the habit of using condoms, attitudes and subjective norms were not significant predictors of intentions to use condoms in the future (r = 0.18 and r = 0.10, p<0.1 in both cases). In contrast, attitudes and subjective norms were strong predictors for participants who were not in the habit of using condoms (r = 0.81 and r = 0.61, p < 0.01 in both cases). These findings were replicated in a second study.