Emotional reactivity and risk for psychopathology among adolescents

Various aspects of personality or dispositional style predict risk for psychiatric disorders among adults. In particular, signs of neuroticism, emotional reactivity, or sensitivity to stress are strong predictors of later mood or anxiety disorders. The current report extends this literature to adolescents. An epidemiologic sample of 776 young people living in upstate New York received psychiatric assessments based on the Diagnostic and Statistical Manual of Mental Disorders, Third Edition-Revised, (DSM-III-R) and a self-report assessment of personality style in 1983 and 1985. Psychopathology was again assessed in 1992. The current study first examined demographic correlates of emotional reactivity. The study then considered the predictive relationship between emotionally reactive personality style at one study wave and psychopathology at later waves. In middle but not early adolescence, girls showed higher levels of emotional reactivity than boys. In turn, high levels of emotional reactivity predicted a range of psychiatric disorders at follow-up. The most consistent associations emerged for major depression and fearful spells, a term the authors use to describe a subclinical form of panic attacks. As in adults, midadolescent girls rate themselves as more emotionally reactive than midadolescent boys. Moreover, adolescents who rate themselves as emotionally reactive face a high risk for mood and anxiety disorders. High levels of emotional reactivity may represent a manifestation of underlying neurobiologic risk for mood and anxiety disorders.     

Parental functioning and children's adjustment in families of divorce: A prospective study

This paper prospectively examined relations between marital status, predivorce parenting practices, and children's adjustment, using data from the New York Longitudinal Study (NYLS). Prospective analyses of children's predivorce adjustment indicated that neither boys nor girls showed more problematic behavior prior to parental separation, and only boys had more difficulties after divorce. However, parents of to-be-divorced families reported more difficulties in childcare practices before divorce than did parents of always-married families. Parenting difficulties in to-be-divorced families were found consistently for boys but not for girls. Results suggest that the difficulties found among boys after divorce may be linked with parenting problems that begin before divorce.The authors are indebted to Alexander Thomas and Stella Chess, the original investigators of the project. We also would like to thank Jacqueline and Richard Lerner, and the John D. and Catherine MacArthur Foundation for their efforts in preserving this data base.     

Childhood disruptive behaviors and family functioning in clinically referred children: Are girls different from boys?

Baseline assessments of 4 to 8-year-old children, 26 girls and 101 boys, referred to outpatient treatment for disruptive behaviors, were examined, focusing on possible differences between the functioning of boys and girls and their families. Child variables included diagnostic information, measures of disruptive behaviors, social competence, and independent observations of child behaviors. A variety of family variables, such as information regarding parenting practices, parental stress, and depression were included. Teacher reports of disruptive behaviors and social competence at school were included. Teacher ratings of child functioning indicated that boys displayed significantly more externalizing behaviors and they were less socially competent than girls. Parents perceived both girls and boys as highly oppositional and aggressive, and generally speaking, differences were few. Nevertheless, the level of stress was higher in girls' than in boys' families, and mothers of girls reported of higher levels of depressive symptoms. Girls and boys did not differ regarding diagnostic status.     

A longitudinal investigation of social causation and social selection processes involved in the association between socioeconomic status and psychiatric disorders.

Social causation theory and social selection theory have been put forth to explain the finding that low socioeconomic status (SES) is associated with risk for psychiatric disorders. The predictions of both theories were investigated using data from a community-based longitudinal study. Psychosocial interviews were administered to 736 families from 2 counties in New York State in 1975, 1983, 1985-1986, and 1991-1993. Results indicated that (a) low family SES was associated with risk for offspring anxiety, depressive, disruptive, and personality disorders after offspring IQ and parental psychopathology were controlled, and (b) offspring disruptive and substance use disorders were associated with risk for poor educational attainment after offspring IQ and parental psychopathology were controlled. These findings indicate that social causation and social selection processes vary in importance among different categories of psychiatric disorders.     

Prospective associations of co-rumination with friendship and emotional adjustment: considering the socioemotional trade-offs of co-rumination

Co-ruminating, or excessively discussing problems, with friends is proposed to have adjustment tradeoffs. Co-rumination is hypothesized to contribute both to positive friendship adjustment and to problematic emotional adjustment. Previous single-assessment research was consistent with this hypothesis, but whether co-rumination is an antecedent of adjustment changes was unknown. A 6-month longitudinal study with middle childhood to midadolescent youths examined whether co-rumination is simultaneously a risk factor (for depression and anxiety) and a protective factor (for friendship problems). For girls, a reciprocal relationship was found in which co-rumination predicted increased depressive and anxiety symptoms and increased positive friendship quality over time, which, in turn, contributed to greater co-rumination. For boys, having depressive and anxiety symptoms and high-quality friendships also predicted increased co-rumination. However, for boys, co-rumination predicted only increasing positive friendship quality and not increasing depression and anxiety. An implication of this research is that some girls at risk for developing internalizing problems may go undetected because they have seemingly supportive friendships.     

Is parental divorce a critical stressor for young adolescents? Grade point average as a case in point.

Previous studies have shown parental divorce to be associated with poor functioning of children and adolescents. Almost all of the studies attempting to delineate these effects, and to shed light on the differences between boys and girls, have limited data collection to postdivorce. This practice has left a void in the picture of divorce--specifically in the area of predivorce effects. The purpose of the present study was to examine academic functioning of young adolescents with respect to both pre- and postdivorce effects. Fifty-eight young adolescents (29 from families which subsequently divorced and 29 from families which remained intact) were studied. Results indicated that boys from subsequently divorcing homes had significantly poorer academic functioning prior to their parents' divorce than did boys whose families remained intact and girls whose parents divorced. Differentially, girls from subsequently divorcing families showed a decline in academic functioning which began prior to divorce and continued beyond the time of divorce. Possible explanations for these gender differences are explored, and the importance of examining predivorce effects is addressed.     

Developmental trajectories of anxiety symptoms among boys across early and middle childhood

This study examined the developmental trajectory of anxiety symptoms among 290 boys and evaluated the association of trajectory groups with child and family risk factors and children's internalizing disorders. Anxiety symptoms were measured using maternal reports from the Child Behavior Checklist (T. M. Achenbach, 1991, 1992) for boys between the ages of 2 and 10. A group-based trajectory analysis revealed 4 distinct trajectories in the development of anxiety symptoms: low, low increasing, high declining, and high-increasing trajectories. Child shy temperament tended to differentiate between initial high and low groups, whereas maternal negative control and maternal depression were associated with increasing trajectories and elevated anxiety symptoms in middle childhood. Follow-up analyses to diagnoses of preadolescent depression and/or anxiety disorders revealed different patterns on the basis of trajectory group membership. The results are discussed in terms of the mechanisms of risk factors and implications for early identification and prevention.     

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.     

Interactive Effects of Psychosocial Stress and Early Pubertal Timing on Youth Depression and Anxiety: Contextual Amplification in Family and Peer Environments

While off-time pubertal development has emerged as a potential risk factor for both symptoms of depression and anxiety in youth, the literature is mixed and inconsistent as to (1) how early versus late pubertal timing confers risk for both boys and girls, (2) if the conferred risk is distinct between symptoms of anxiety and depression, and (3) under what social contexts (e.g., family environment, peer relationships) off-time pubertal development may emerge as a potent risk factor for these symptoms. The present study examined the impact of perceived pubertal timing on symptoms of anxiety and depression in two distinct psychosocial contexts: parent’s perceptions of their own harsh parenting and parent’s perceptions of their child’s peer problems. The sample consisted of 412 parents (M = 38.6 years old, SD = 7.8, 60.4 % mothers) of children between the ages of 8 and 17 (M = 12.13, SD = 2.97, 45.4 % girls). All constructs were assessed by parent reports. Linear multiple regression analyses revealed that the interaction between earlier pubertal timing and greater peer problems was significantly related to higher youth depressive and anxiety symptoms. The interaction between earlier pubertal timing and greater harsh discipline was significantly related to higher youth anxiety but not depressive symptoms. Youth gender did not qualify findings. Results suggest that the contextual amplification process of early pubertal timing may occur in both high stress family and peer environments and impact both girls and boys.     

Youth Suicide in Norway, 1990–1992: A Comparison between Children and Adolescents Completing Suicide and Age- and Gender-Matched Controls

In Norway 1990–1992, the suicide rate was 18.6 per 100,000 individuals per year for boys 15–19 years old and 6.3 for girls, and for 10–14 year olds the rate was 2.7 for boys and 0.5 for girls. Comparison of all completed suicides (N = 129) with gender- and age-matched control subjects identified depression (OR = 19.9; CI = 11.2, 35.5), disruptive disorders (OR = 6.0; CI = 3.1, 11.4), and previous suicidal behavior (OR = 3.4, CI = 2.0, 5.6) as main risk factors. Of the suicide completers, 74% had mental disorders. Suicidal intent was previously expressed by 48%, but few (24%) had received treatment, despite well-developed health services. A history of disruptive disorders (17%) and substance abuse (10%) were less frequently found than in previous studies, but binge drinking may contribute to the adolescent suicide rate.     

HIV/AIDS communication among adolescents in psychiatric care and their parents.

The authors examined HIV/AIDS communication among 207 parent-adolescent dyads in psychiatric care to better understand the relationship between family communication and sexual risk behavior in an at-risk population. Dyads reported content and rated quality of family HIV/AIDS discussions, and adolescent sexual risk was assessed. Families discussed transmission, prevention, consequences, myths, and compassion. Parent-reported discussion of consequences was associated with greater sexual risk behavior, but only for girls. Higher quality communication reported by adolescents was associated with less sexual risk. Parents may send different messages about HIV/AIDS to sons versus daughters, and messages related to consequences may not effectively reduce risk among daughters. However, for boys and girls in psychiatric care, teaching parents how to discuss HIV/AIDS may promote safer sexual behavior.     

Psychiatric Disorders Associated with Substance Use Among Children and Adolescents: Findings from the Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study

The relationships between specific quantities and frequencies of alcohol, cigarette, and illicit substance use and substance use (SUD) and other psychiatric disorders were investigated among 1,285 randomly selected children and adolescents, aged 9 to 18, and their parents, from the Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study. Logistic regressions indicated that daily cigarette smoking, weekly alcohol consumption, and any illicit substance use in the past year were each independently associated with an elevated likelihood of diagnosis with SUD and other psychiatric disorders (anxiety, mood, or disruptive behavior disorders), controlling for sociodemographic characteristics (age, gender, ethnicity, family income). The associations between the use of specific substances and specific psychiatric disorders varied as a function of gender.     

Prospective incidence of first onsets and recurrences of depression in individuals at high and low cognitive risk for depression

Do negative cognitive styles provide similar vulnerability to first onsets versus recurrences of depressive disorders, and are these associations specific to depression? The authors followed for 2.5 years prospectively college freshmen (N = 347) with no initial psychiatric disorders at high-risk (HR) versus low-risk (LR) for depression on the basis of their cognitive styles. HR participants had odds of major, minor, and hopelessness depression that were 3.5-6.8 times greater than the odds for LR individuals. Negative cognitive styles were similarly predictive of first onsets and recurrences of major depression and hopelessness depression but predicted first onsets of minor depression more strongly than recurrences. The risk groups did not differ in incidence of anxiety disorders not comorbid with depression or other disorders, but HR participants were more likely to have an onset of anxiety comorbid with depression.     

Variation in hypothalamic-pituitary-adrenal axis activity among bullied and non-bullied children

We examined the relationship between being bullied during childhood and activity of the hypothalamic-pituitary-adrenal (HPA) axis as assessed through repeated measures of salivary cortisol. A non-clinical sample of 154 (74 boys) predominantly Caucasian middle-class 12-year-olds each provided detailed information about their experiences with bullying and six saliva samples were standardized across time and day. Children with a history of child maltreatment, diagnosed psychiatric illness, foster care placement, medication use (psychotropic and oral contraception) and aggression directed toward peers and/or family members were excluded. Using multilevel regression and applying orthogonal polynomial contrasts to model the observed circadian pattern in the data, we found that occasional and frequent verbal peer victimization was associated with hyposecretion of cortisol when controlling for sex, pubertal status, age, depression and anxiety. This relation, however, was moderated by sex. For boys, occasional exposure was associated with higher cortisol levels, whereas for girls exposure was associated with lower cortisol levels. The present study highlights the need to consider the plight of peer-victimized children seriously, as it is associated with alterations to the HPA axis that affect males and females differently, and likely diminishes a person's ability to cope with stress, possibly placing them at risk for psychopathology and ill health.     

Is an interest in computers or individual/team sports associated with adolescent psychiatric disorders?

The Internet plays a major role in adolescents' free time activities and communication nowadays. The aim here was to investigate the possibility of an association of computers and video games or sports (team, individual) with psychiatric disorders among underage psychiatric inpatients. The series of adolescents (n?=?508) had been diagnosed using semistructured interviews (K-SADS-PL). The results showed that an interest in computers and video games did not increase the risk of any specific psychiatric disorder among these adolescent inpatients, but the likelihood of a substance-related disorder was statistically significantly lower among the boys with computers as a hobby. Team sports were related to increased likelihood of conduct disorder among the boys, whereas the likelihood of an affective disorder was reduced. No such association was found in individual sports or among the girls. We conclude that social contacts and peers play an important role in preventing adolescent depression.     

Paternal Psychiatric Symptoms and Maladaptive Paternal Behavior in the Home During the Child Rearing Years

Data from the Children in the Community Study, a community-based longitudinal study were used to investigate associations between paternal psychiatric disorders and child-rearing behaviors. Paternal psychiatric symptoms and behavior in the home were assessed among 782 families during the childhood and adolescence of the offspring. Paternal anxiety, disruptive, mood, personality, and substance use disorders were independently associated with specific types of maladaptive paternal behavior in the home during the child-rearing years after paternal age, education, income, co-occurring paternal psychiatric symptoms, offspring age, sex, intelligence, temperament, and psychiatric symptoms were controlled statistically. Paternal psychiatric disorders that were present by mean offspring age 14 were associated with elevated risk for maladaptive paternal behavior in the home at mean age offspring 16, after prior maladaptive paternal behavior was controlled statistically. These findings suggest that paternal psychiatric disorder may be an important determinant of maladaptive paternal behavior in the home during the child-rearing years. Improved recognition and treatment of paternal psychiatric disorders may help to reduce the amount of maladaptive parenting behavior that many children and adolescents might otherwise be likely to experience.     

Peer functioning, family dysfunction, and psychological symptoms in a risk factor model for adolescent inpatients' suicidal ideation severity

Examined models of suicidal ideation severity that include two psychosocial risk factors (i.e., peer and family functioning) and four domains of psychological symptoms (i.e., generalized anxiety, depression, conduct problems, and substance abuse/dependence). Participants were 96 psychiatric inpatients (32 boys, 64 girls), ages 12 to 17, who were hospitalized because of concerns of suicidality. Adolescents completed a structured diagnostic interview, measures of suicidal ideation, and several dimensions of family and peer functioning. Results supported a model in which greater levels of perceived peer rejection and lower levels of close friendship support were associated directly with more severe suicidal ideation. In addition, indirect pathways included deviant peer affiliation and global family dysfunction related to suicidal ideation via substance use and depression symptoms. The results are among the first to demonstrate relations between suicidal ideation and several areas of adolescent peer functioning, as well as divergent processes for peer and family predictors of suicidal ideation.     

Personality factors, family structure, and sex of drawn figure on the Draw-A-Person Test

One hundred seventy-four youthful psychiatric inpatients were given the Draw-A-Person Test (DAP) as part of an assessment battery. Sex of person drawn was compared to subject's sex, Achenbach aggression and delinquency scores, and scores on Children's Inventory of Anger and Nowicki-Strickland Locus of Control Scale. The sex of the person drawn was also compared to family composition, specifically whether or not the child came from an intact family with both a male and female parent or role model. Results support drawing of a same-sexed individual as normative, regardless of age or sex. Adolescent girls and young boys were the only groups that differed significantly from this norm. Personality measures and family composition were not significantly related to the tendency to draw same versus opposite sex.     

Relevance of the Tripartite Dimensions of Affect for Anxiety and Depression in Youth: Examining Sex and Psychopathology Status

Using a combined sample (N = 1,215) of referred children and children from the general population aged between 8 and 14 years, the present study addressed two research goals: First, latent mean differences (depending on the individual’s sex or psychopathology level) in anxiety, depression, Positive Affect (PA), Negative Affect (NA) and Physiological Hyperarousal (PH) were examined. Secondly, the structure of anxiety and depression was investigated from a tripartite model perspective in boys and girls with high versus low levels of psychopathology respectively. When relating the latent mean level differences in NA, PA, and PH with those in anxiety and depression, the results suggest that higher levels (depending on the individual’s sex and psychopathology status) of anxiety or depression are associated with higher levels of PH and lower levels of PA, whereas no consistent pattern was found between mean level differences in NA on the one hand and mean level differences in anxiety/depression on the other. Results further demonstrated that a better fit was obtained for the dual than for the unitary construct representation in boys or girls with high or low levels of psychopathology, thereby suggesting that a valid distinction can be made between anxiety and depression in children between 8 and 14 years old, irrespective of their sex or level of psychopathology. However, when looking at the structural relations of the dual construct representation of anxiety and depression with NA, PA and PH in each of the four groups separately, it became evident that the PH and PA tripartite dimensions could not account for the unique aspects of anxiety and depression respectively. Moreover, PH rather than NA was found to be common for anxiety and depression.     

Testing the Direction of Longitudinal Paths between Victimization,Peer Rejection,and Different Types of Internalizing Problems in Adolescence

The transition to secondary school is accompanied by the fragmentation of peer groups, while adolescents are also confronted with heightened incidents of bullying and increased levels of internalizing problems. Victimization, peer rejection, and internalizing problems are known to be interrelated, but how they influence each other over time remains unclear. We tested the direction of these associations by applying a cross-lagged path model among a large sample of Finnish adolescents (N = 5645; 49.1 % boys; M age at T1 = 14.0 years) after they transitioned to secondary school (grades 7–9). Self-reported depression, anxiety, and victimization and peer-reported rejection were measured 3 times over the course of 1 year. Results showed that depression was predictive of subsequent victimization for both boys and girls, in line with a symptoms-driven model; for girls, anxiety was reciprocally related to victimization, in line with a transactional model; for boys, victimization was related to subsequent anxiety, in line with an interpersonal risk model. Peer rejection was not directly related to depression or anxiety, but among girls peer rejection was bi-directionally related to victimization. Overall, our results suggest that associations between internalizing problems and peer relations differ between depression and anxiety and between genders. Implications for practice and directions for future research are discussed.